An infectious disease specialist says Alberta seems to be taking a more focused, cautious approach to easing a few COVID-19 restrictions, which he says will allow the province to monitor the impacts of those changes more closely and get an accurate look at potential risk.
Dr. Craig Jenne, a Calgary infectious disease specialist, says Albertans have been doing a good job at reducing transmission and the numbers are starting to show that.
“Many of us are surprised that we haven’t seen a Christmas surge, which is, you know, fantastic news,” he said Friday.
“We’ve seen, over the past several days to a week, a fairly steady — slow but steady — decline in positivity rates in the province. That’s encouraging because that’s independent of the number of patients we’re testing.”
On Thursday, the percentage of people who had COVID-19 out of the total number of people tested was 5.8 per cent.
There were 806 Albertans in hospital with the disease, 136 of whom were in intensive care. Alberta Health reported 21 additional deaths from the disease on Thursday.
“We’ve also seen hospitalizations and ICU stabilize,” Jenne said. “So we’re not seeing that exponential growth, suggesting that we are now beginning to control the spread of virus in the community, and we are starting to see a decline. So those are the normal indicators for beginning to reassess our restrictions.”
Doctors respond to new restriction easements
Health Minister Tyler Shandro announced Thursday that, effective Monday, Jan. 18, outdoor gatherings of up to 10 people would be permitted, as long as other health measures like masking and physical distancing were observed. He also said personal wellness services, like hair salons and other aesthetics, could re-open by appointment only.
Jenne said in the past, Alberta relaxed more rules at once, making it harder to track which activities are higher risk.
“This is a much more cautious strategy and probably a much safer strategy.
“…To slowly unpack some of these restrictions, identify activities in the community that are very low risk, such as small gatherings outdoors, and then begin with those, and provide a little bit of time to check what impact that has on viral numbers.
“And if things continue to decline, I’m sure over the next few weeks, we’ll see another reassessment and perhaps another round of easing of restrictions.”
The province also said the capacity limit on funerals would be eased, meaning funeral services with up to 20 people would be allowed effective Jan. 18. Funeral receptions are still not permitted.
Jenne says this indicates the province is looking at low-risk activities but also what Albertans need.
“An easement on the number of people that can attend a funeral are critical to mental health and community strength,” he said. “We’re identifying the things that are most critical, lowest risk, and also providing a little time to judge their impact before moving to next steps.”
“We have to have people realize that positive numbers or encouraging trends are not a green light to start gathering again, and that if we choose to shake these restrictions, we will be driving virus back up. It becomes a very self-defeating success that the more encouraging the numbers get, the less strictly we follow those limits,” Jenne said.
“The virus does take advantage of that.”
Dr. James Talbot is former chief medical officer of health for the Alberta government (2012 to 2015) and co-chair of the Strategic COVID-19 Pandemic Committee, created by the Edmonton Zone Medical Staff Association (EZMSA), which represents about 1,700 doctors.
He says, bottom line, the new easements might be okay, but Alberta should wait four weeks before opening anything else.
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The committee has written a series of suggestions to the province, advocating a “controlled, phased, evidence-driven relaxation of the circuit breaker.”
“Pay particular attention to… whether community transmission is going up or down. Pay attention to the stress that hospitals are under, make sure you’re monitoring for that new strain and the contact tracing is up and there aren’t any backlogs,” Talbot said.
“Our advice is that as the circuit breaker is relaxed, that it’s done in a phased, in a controlled and in an evidence-based way. And so the steps that you’ve seen so far would then fit.”
However, improving the contact-tracing system is a huge part of a successful plan, Talbot said.
While the current numbers are encouraging, Dr. Stephanie Smith would have liked to see the restrictions in place over the holidays remain for a bit longer.
“We still have an approximate five per cent positivity rate, which is high, and if we open up too soon, I think we would risk seeing increases in transmission,” said Smith, an infectious disease physician and director of infection prevention and control at the University of Alberta Hospital.
“This would necessitate another lockdown, which would be very challenging for Albertans and not engender a lot of confidence in the government.”
Speaking to Global News before the new easements were announced Thursday, Smith said she wanted the December restrictions continued until Alberta recorded “sustained and significant declines in the number of positive people in the community and in hospital.”
However, she is hopeful that now that a larger number of Albertans at high risk for severe outcomes have been immunized, that will help ease pressure on the health-care system.
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Businesses react to restriction easements
The owner/operator of High Wire Tattoo in Calgary was a bit shocked to hear he’d be allowed to open on Monday.
“I thought we’d be waiting a little bit longer,” Darren Parnell said. “I was a little bit surprised that we did get allowed to work so quickly – but appreciative.”
He said everybody is pretty excited to reopen.
“The phone’s ringing, which is nice.”
Parnell said two separate shutdowns have been tough financially.
“It has been a bit challenging for us,” he said. “The government definitely does reach out and help, it has played a good part in that. So we’re grateful for that. We’re grateful for our clients and definitely not living beyond our means.
“We don’t look forward to a third lockdown or a third shutdown, but definitely I always have it in the back of my head… Not living beyond your means and being prepared is utmost when running a small business during a pandemic.”
In Leduc, the uncertainty was too much for Skull Krew Tattoo.
“I’m very relieved that we can go back to work, that those restrictions have been lifted,” co-owner Sherry Bowie said. “Unfortunately, for us, it does feel a little too late.”
She said the lockdowns have been hard on small businesses and also hard on their regular customers. Skull Krew lost about 70 per cent of its standard clientele over the first lockdown.
“We’ve spent the last few months trying to recover financially, on our client base, as well as mentally and emotionally, from the changes that came through the first lockdown.”
This week, the business decided to close its storefront location.
“At this point, we can no longer maintain a storefront business,” Sherry said. “We’re simply just accruing more bills and going further and further into the red and we don’t even know if we’re going to be able to stay open to pull ourselves out of the red.
“We won’t be closing our studio entirely. We are looking into our satellite options, other studios that suit our one-on-one needs.”
The provincial government’s announcement made her feel a mix of emotions.
“It’s exciting because we can go back to work, we can show the province what we’re capable of, how safe it is. Our clients are excited as well… But there is the fear that another lockdown may come.
“We’re absolutely fearful that if those numbers rise, we could be facing another lockdown with no given date as to when we could reopen.”
For owner and 15-year tattoo artist Robby Bowie, this week marks the end of an era.
“With all the uncertainties of these lockdowns, it’s a complete gamble. We might do well, we might not. If the numbers rise and I’m forced to close again, that’s more recurring bills,” he said.
“They said they’d give us a week’s notice to try to get back to work then all of a sudden, we hear last night that, OK, it’s a go, which is great, but too little too late. We already made the decision. I’ll still be working… I’m not going to quit. I’ve got to feed my family… But unfortunately I won’t be able to do it here.”
Alberta officials on easing restrictions
Alberta’s chief medical officer of health described the Jan. 18 change “a test case.”
“This is our opportunity to give Albertans a little bit more freedom and the ability to do a few more activities in a safe way,” Dr. Deena Hinshaw said Thursday. “We are going to be able to then consider, going forward, whether or not we can ease a few more measures if, despite these decisions and actions today, we continue to see that downward trend in our hospitalization, ICU admissions, cases and positivity.”
Those are the metrics officials are watching, she said, to see what effect reopening schools and these new easements will have.
“What we need to see is continuing reductions in our hospitalizations and ICU with respect to that target of decreasing the impact on the health system — that is absolutely essential. We need to see a reduction in our new case numbers and a reduction in our positivity rate… When we have very high numbers, it’s important to see our R value below one, as low as possible.”
“The changes need to be done in a very slow manner so that we can monitor them and how it impacts our overall case numbers is up to all of us.
“If we continue to follow those basic public health measures in all of our activities, including these new activities that have opened up, we can continue to have a downward trend at the same time as enjoying a few more activities in a safe way,” Hinshaw said.
The biggest metric, Shandro said, will be the pressure on the health-care system.
“All the restrictions, measures are placed on different activities depending on different levels of risk. So for each of them, we’re going to have to look at those levels of risk. Obviously, outdoor gatherings have a different level of risk than indoor gatherings, for example.
“So depending on the level of ICU admissions and hospitalizations, as well, as Dr. Hinshaw said, looking at R values where they can be calculated — Calgary and Edmonton and provincewide — we look at that data and those metrics to be able to make those decisions on the different activities depending on the risk.”
“We also need to take into consideration the fact that there are two variants of the COVID virus: the D117 variant which was first identified in the United Kingdom as well as the 507Y-V2 variant which was first identified in South Africa,” Shandro said.
“These variants require us to continue to take a cautious and pragmatic approach. We’ve seen escalating case counts in other countries because of the infectiousness of these variants and we must not move too quickly.”
Strategic COVID-19 Pandemic Committee’s letter to Premier Kenney by Emily Mertz on Scribd
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