More than a month after the U.S. Centers for Disease Control and Prevention updated their COVID-19 guidance for fully vaccinated Americans, the growing number of Canadians joining their ranks still have little to go on when it comes to understanding what — if anything — they can do differently.
On Tuesday, the question of why Canada hasn’t yet followed suit with its own recommendations was lobbed repeatedly to Dr. Theresa Tam, the country’s chief public health officer.
Tam, who has become one of the country’s most trusted officials during the pandemic, said while the Public Health Agency of Canada is working on it, there’s no easy answer for when or under what circumstances Canadians can finally whip off the masks.
“It’s not the same in every part of the country,” she cautioned.
Tam said the focus has been on making sure everyone can get a vaccine and that vaccination levels in communities get high enough that fully vaccinated Canadians venturing out into public can do so with the assumption that a large number of the people around them have are also fully vaccinated.
But even once that happens, it appears likely any advice from federal health officials will focus more on giving people tools and frameworks to make their own decisions, rather than an overarching, national green light for when it’s safe to ditch the masks.
“Now that so many more Canadians have got their double vaccination, as Dr. Tam said, I think in the coming days and weeks you will see the federal government coming out with different types of risk assessment tools,” said Dr. Howard Njoo, the country’s deputy chief public health officer.
“There’s no single-size-fits-all. You can’t tell everybody, ‘Yes, you can all do this.'”
“It really depends on your individual context,” Njoo explained.
A risk assessment framework or tool is a different approach from the U.S. CDC, which issued a blanket advisory on May 13 that anyone who is fully vaccinated can “resume activities without wearing a mask or physically distancing,” except where mandated by local law to do so.
That advice has prompted signs like the one below at a Seattle baseball game on May 17, where fans were told via giant screen that those who are fully vaccinated were “no longer required to wear masks” and could sit in a special section of the stadium to watch the game.
In Canada, whether similar signs go up will likely depend on when the provinces, which are each responsible for their own public health rules, and municipalities decide to change their own rules.
Michelle Gosselin, a health-care worker at an Ottawa hospital, told Global News outside city hall on Wednesday that although she received her second dose of a COVID-19 vaccine two weeks ago, she is still double-masking on the job and while out in public because of the uncertainty around new variants.
In particular, she pointed to the spread of more contagious variants as a risk while the country keeps assessing the effects of the vaccine rollout on the spread of the virus in Canadian communities.
“We can’t just really dive in head first to deep water — we should really just test the water first with our toes and go slow.”
Gosselin’s response was echoed by Susan Lindsay, an Ottawa mother with both doses who spoke to Global News at the same spot along with her 16-year-old son, who had just received his first dose.
“I don’t want to follow the U.S. lead in any way shape or form because most of their decisions are informed by politicians,” Lindsay said when asked whether she would like to see advice like that of the CDC.
“It probably seems slow but we could probably rush out again and then have to roll back, which I think would be more devastating than a slow rollout.”
Some COVID-19 guidance will be key, say experts
The rapid spread of the highly infectious Delta variant across the world has prompted concern in recent weeks, especially in countries where all or most of the population remains unvaccinated.
But even in countries like Canada with high — and growing — vaccination rates, the spread of the Delta variant also has many health officials concerned. For example, testing is still required for Canadian returning travellers even as quarantine requirements are set to ease for the fully vaccinated on July 5.
Tam said while the vaccines provide “critical protection,” the potential for more infectious variants to spread is a big part of why those testing requirements and bans on non-essential foreign nationals remain in place.
As of Wednesday, 73 per cent of Canadians over the age of 12 have at least one dose of a COVID-19 vaccine, which represents 64.2 per cent of the total population. The rate of those over the age of 12 with both doses is 14.6 per cent, which is 12.8 per cent of the total population.
Dr. Raywat Deonandan, an epidemiologist with the University of Ottawa, said he understands the confusion as some look at the U.S. advice and wonder why the Canadian government isn’t offering the same.
But he said there are critical differences between Canadian and American societies, and how we gauge risk both to individuals and to the broader community — and which one gets priority.
“What the CDC did was amenable to the American cultural situation, which is very individualistic: ‘I’ve got my doses — what could I do?’ Rather than: ‘The community has this many doses — what’s the burden of the disease in the community that allows them to open certain things?'”
Deonandan said since the beginning of the pandemic, there’s been a struggle to disentangle “individual risk from population risk,” and assessing when to lift guidelines is part of that balance.
“The reason we have vaccinations, for example, is to imbue immunity into the population — to prevent penetration of the virus deep into the communities,” he said. “Yet we continue to think about this and talk about this as if it’s an individual endeavor to seek protection for oneself.”
What will likely happen, said another infectious disease specialist, is a “transition period.”
“We don’t want people throwing off their masks all at once,” said Dr. Sumon Chakrabarti, who works with the Trillium Health Partners hospital network in Mississauga, Ont. “But I think it’s important for us to know what direction we’re heading, and we’re in a very, very good position right now with vaccination.”
Chakrabarti said he hopes to see more guidance from federal health officials to help Canadians make the safest decisions for themselves and their families. As it stands now, he said Canada is “late in the game” at offering that, and the worry is that people start making decisions that could increase their risk.
“If we don’t have guidance, there will be a large number of people who are forging their own rules or going their own way,” he said. “And it might not be safe.”