Alberta is now fully re-opened after 16 months of COVID-19 measures, however, doctors who have been on the frontlines say they plan to monitor what transpires in the coming weeks.
The province has lifted nearly all public health measures, including the provincial mask mandate, though masks will still be required in acute care facilities, continuing care and in public transit, taxis and rideshares — as well as inside establishments in the city of Calgary.
The reopening comes as worries continue over the Delta variant, which is considered more transmissible and has become the dominant strain in many countries around the world.
Dr. Neeja Bakshi, a COVID unit physician at the Royal Alexandra Hospital, said she will also be watching hospital admissions two weeks from the date of reopening, as well as two weeks out from the August long weekend.
“If we start to see a trend like we did before, where we’re seeing consistently one or two admissions a day — where we’re starting to see it’s starting to pick up, specifically maybe in communities or in cohorts, amongst families, I’d like to see that we take a little more action,” she said.
Bakshi said the summer will help with case numbers as people flock outdoors, but she has worries about some summer activities.
“We have upcoming events coming up in the province where there could be large congregates of people. Everyone is tired of COVID and wants to gather, and I think it’s OK to gather safely and making sure you’re looking at your own risk,” she said.
Dr. Sean van Diepen, a professor of critical care medicine at the University of Alberta, said cases could rise in two weeks, though it may be more likely to happen in the fall when children return to school and people return indoors with the colder weather.
“The big unknown will be what this potential fourth wave or rise will look like,” he said.
“I think an increase in case counts is likely or probable based on what we’ve seen internationally, but the effect on the healthcare system — specifically in terms of hospitalizations or admissions to ICU — that will be the big unknown.”
Van Diepen said it will be important to watch and learn from other countries, such as the United Kingdom and Israel, to see what, if any, action may be required after reopening.
Case counts are rising in the United Kingdom and the Delta variant is now the dominant strain; Prime Minister Boris Johnson is aiming to speed up vaccination plans to immunize adults by July 19 — the new date which he plans to end COVID restrictions in England.
Meanwhile, Israel has been leading the world in vaccinations but Thursday, it reported its highest daily infection rate in three months as it scrambles to contain the Delta variant.
In recent months, Israel has reopened businesses, schools and event venues, lifting nearly all restrictions after it inoculated some 85 per cent of the adult population. It’s now seen as an early warning system of sorts for other nations.
“I would hope we can learn from their numbers and their hospitalization rates to see what their thresholds would be to reinstitute public health measures,” van Diepen said.
The World Health Organization recently recommended fully vaccinated people wear masks indoors because of the Delta variant. Though the provincial mask mandate no longer exists, van Diepen said he still recommends wearing a mask indoors in small social gatherings and at work.
“I’m basing that largely on the Israeli experience where they rolled back indoor mask mandates and they’ve now seen an uptick, largely due to the Delta variant,” he said.
Chief medical officer of health Dr. Deena Hinshaw has previously said that as more people are vaccinated, case counts will not drive action – or public health measures – like they did previously in Alberta, noting vaccines are protective against infection and severe outcomes.
Hinshaw said the UK is not seeing hospitalizations rise in the same way as previous waves. She also said that while the U.K. had not yet been able to vaccinate younger age groups when the Delta variant first began to spread, Alberta has been vaccinating those as young as 12 years old for weeks.
“If we do see cases start to rise in Alberta, that doesn’t necessarily mean we’re going to see severe outcomes rise in the same way. Without that correlation, it would not be appropriate to use those case counts with exactly the same thresholds we’ve used previously.
“We will be looking at all the indicators but particularly looking at impacts on severe outcomes and if we start to see those impacts rise, those will be the biggest concern,” she said.
Van Diepen, in response to Hinshaw’s comments, said it all depends on how many case numbers there are.
“Obviously you want to prevent disease, severe disease, and you want to prevent transmission, but I think that depends on the absolute numbers; 500 is different than 2,000,” he said.
Bakshi further said she doesn’t think high case counts, but lower hospitalization rates should be acceptable, citing how those who test positive still have to isolate, which could affect income or schooling.
“I think the ramifications of having COVID go far beyond just hospitalization. That’s a big indicator and I know that’s what we’ve been using in this province for our opening, reopening, closing… For that reason, I don’t think we should be accepting that higher numbers are OK,” she said.
-with files from Reuters and The Associated Press