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Alberta doctors nervous about Stage 3 of reopening, pointing to more transmissible Delta variant

Alberta is speeding up the timeline for second doses of the COVID-19. Plus, what does moving into Stage 3 of the Open for Summer plan mean for vaccinations in the province? Julia Wong explains. – Jun 18, 2021

The province will fully reopen on Canada Day, an announcement that has some Alberta doctors on edge due to a more transmissible variant.

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On Friday, Premier Jason Kenney announced Alberta will move into Stage 3 of the Open for Summer plan on July 1, after it hit the threshold of 70 per cent of eligible Albertans with at least one dose of a COVID-19 vaccine. Stage 3 would see Alberta’s economy fully reopen, with few measures in place.

READ MORE: COVID-19: Alberta public health measures to end on July 1

Dr. Stephanie Smith, an infectious disease physician at the University of Alberta Hospital, said she is slightly nervous about a full reopening.

“I feel a little bit like we are going from zero to 100. Is there some kind of middle ground of restrictions as opposed to going from fairly significant restrictions to almost nothing?” she said.

READ MORE: Delta COVID-19 variant: A look at the risks, symptoms and impact on vaccines

Doctors are concerned about the Delta variant or B.1.617.2 sub-lineage, which is more transmissible than the Alpha variant or the B.1.1.7 variant; research has shown a single dose of vaccine offers less protection against the Delta.

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If Delta variant cases start to increase, Dr. Chris Mody, head of the University of Calgary department of Microbiology, Immunology and Infectious Diseases, said there may potentially be problems.

“What I would like to see is us put the brakes on that before, or at least slow the reopening slightly to prevent that from happening,” he said.

“What we need to do is we need to prepare for another surge in cases towards the end of July and we may have to react to that.”

READ MORE:Canada’s COVID-19 vaccine targets could change in wake of Delta variant, Tam says

However, when asked whether the province could move back in its reopening plan if hospitalization numbers or the virus’s reproductive value go up, the premier said he doesn’t foresee that scenario.

“This is open for good, not just open for summer. We will have to, from time to time, address localized outbreaks and I fully expect we will see an increase in cases, particularly with the typical seasonal wave for contagious diseases of this nature,” Jason Kenney said.

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Dr. Kelly Burak, an epidemiologist and professor of medicine at the University of Calgary, said this virus has shown the importance of being nimble.

“The science evolves very rapidly. The plan that was laid out a month ago doesn’t necessarily mean that it’s a good idea right now,” he said.

“To say it’s full steam ahead and that we’re not going to pay attention to important markers is concerning and frustrating.”

The vaccination threshold for Stage 3 has now been met, but doctors say it should not be the end of the road. The province is encouraging Albertans who have yet to book a first dose to do so.

Smith said it’s important to look at what the issues are in the 30 per cent who have not received a first dose.

“What we can do to help them in terms of seeing the benefits of vaccination. If it’s vaccine hesitancy because there’s concerns about side effects, I think we really need to ensure that we have the correct messaging,” she said.

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“If it’s issues of access then how do we ensure that people in rural areas have better access? Depending on the area we need to tailor our approach in terms of what we need to do to try to continue to get people to get a first dose.”

Public health measures will be lifted in Stage 3, though there may still be some restrictions in place at acute care facilities and long-term care.

The doctors said Albertans need to be mindful, even as things start to get back to normal.

“What we have as tools is the second dose, to get that [protection] up to 70 per cent and then we have public health measures. We should still maintain social distancing – six feet – we should be wearing masks until we figure out what’s going on with the delta,” Mody said.

READ MORE: Alberta expanding COVID-19 vaccine rollout for second doses

The province has moved up timelines for second doses; those who received their first dose in May are now able to book their second dose and those who received their first dose in June are being asked to wait four weeks before booking their second dose.

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“The more people who get a second dose, the less likely the delta variant will take hold in Alberta and less likely we’re going to have to impose really restrictive public health measures,” Mody said.

Burak said, with the Delta variant, it is not a matter of if a fourth wave could happen but, rather, when. He said timing will depend on vaccination numbers but also individual responsibility.

“How much people let their guard down, the mixing and mingling that people with no protection who are unvaccinated or with just one dose, the more likely it’s to take off,” he said.

Kenney defended Alberta’s plan on Friday, saying half of the delta variant cases in the province are “very localized.”

“At this stage of this, I don’t think it’s responsible constantly to be spreading fear. We need to be embracing the science of the protective effect of vaccines,” he said.

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“The promoters of fear will have lots of variants to come in the future. There will be new variants. They will be more contagious. The scientists will study them. If necessarily, the vaccines in the future will be adjusted to be more protective against future variants. If other countries with lower levels of protection can get back to normal, why can’t Alberta?”

Burak said, if the Delta variant takes hold, case counts could go up very quickly, pointing to the experience of other countries such as the United Kingdom; other factors include reopening while most Albertans have a single dose.

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“Our hope is with more people vaccinated, [we] might see less hospitalization with the next wave,” he said.

“Unfortunately we will see fourth wave.”

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