After over a year of back-and-forth public health restrictions aimed at keeping Canadians safe from COVID-19, experts say that the final lockdown might already be behind us — and that we can soon start mentally preparing for close quarters with sweaty crowds.
The news comes as multiple provinces are moving forward with reopening plans — a direct result of the enthusiastic uptake of COVID-19 vaccines.
Over 75 per cent of Canadians over the age of 12 have received at least one vaccine dose, and more than 20 per cent of Canadians have been fully vaccinated.
This is a good sign for a permanent return to normal, experts say.
“I don’t want to sound overconfident, but I think the chances are very unlikely to lock down again,” said Sumon Chakrabarti, an Infectious Diseases Physician at Trillium Hospital in the Greater Toronto Area.
Case counts don’t mean what they used to
While case counts continue to fluctuate, Chakrabarti explained that this figure is rapidly becoming less important compared to hospitalizations when it comes to predicting potential lockdowns.
That’s because, while there’s still a chance you might catch COVID-19 even if you’re fully vaccinated, the prevention of severe outcomes is where the vaccines really shine.
Clinical trial data from all five vaccines Canada has considered for approval — Pfizer, Moderna, Novavax, Janssen and AstraZeneca — showed that every single jab was extremely effective at preventing hospitalizations.
“If you look across all the clinical trials, of the tens of thousands of people that were involved, the number of cases of people that died from COVID-19 that got (vaccinated) was zero. The number of people that were hospitalized because their COVID-19 disease was so severe was zero,” said Health Canada’s Dr. Surpiya Sharma, speaking in late February, when vaccines started rolling out in Canada.
“So in the areas where we’re really looking to prevent serious illness, prevent hospitalizations, and of course prevent death, all of these vaccines are good.”
Even as fresh variants have started threatening vaccine progress, Chakrabarti pointed out that the mutated versions of the virus do spread more easily — but they don’t necessarily appear to be more deadly.
“The main issue with the variants like, say, Alpha and Delta, is that they’re more transmissible,” said Chakrabarti.
He said that transmissibility becomes an issue when the hospitals are full. But with vaccines forcing hospitalization numbers down and allowing ICUs to breathe a sigh of relief, “we can absorb” an uptick in cases, according to Chakrabarti.
“What’s the reason that we got locked down? Well, it’s because we have too many hospitalizations all at once,” he said.
“And now, with the vaccine significantly reducing that to the point that it makes it something manageable in the health care system, there’s no worry about locking down.”
Chakrabarti isn’t the only expert feeling cautiously optimistic that the finish line for COVID-19 may well be within sight. Another lockdown is looking less and less likely every day, according to Dr. Matthew Miller, assistant dean at McMaster University’s department of biochemistry and biomedical sciences.
“I think these vaccines are going to get us out of this and get us back to normalcy in the very near future,” Miller said.
Before the vaccines, an increase in case counts served as a reliable indicator of a future jump in hospitalizations. However, with a quickly rising number of Canadians getting their shot and building immunity against the virus, case counts aren’t the reliable indicator they used to be.
“Even in the face of challenges like the Delta variant, vaccinated people who get infected — those are going to be rare, first of all — and when it does happen, all the data (suggest) that those infections tend to be extremely mild,” Miller explained.
“So that’s going to take a lot of pressure off of hospitals, and it’s also just going to generally lower the public health risk. Because these infections will turn into something, when they breakthrough, that’s much more akin to a common cold.”
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Hospital capacity a concern
Dr. Isaac Bogoch, who is an infectious diseases specialist, agreed that while “it’s hard to be confident about anything in the COVID-19 era,” he still believes “we shouldn’t have to lock down again.”
One way of bolstering our odds of keeping the country’s COVID-19 measures relaxed is to beef up Canada’s ICU capacity, he added.
“What’s crazy and really somewhat disturbing to me is that we had to shut down … Ontario during the third wave because our health care system capacity was being exceeded,” Bogoch said.
“That happened with 900 patients admitted to Ontario ICUs with COVID-related illness. That’s not very many people in a province of 14.5 million people … That’s actually concerning.”
As Canada enters the flu season and hospitals face slightly more pressure, he warned that this small ICU capacity could become a problem — though “we should be in good shape.”
“But again, I can’t look you in the eye and tell you with a straight face what our health care system capacity is going to become December 2021.”
What about the unvaccinated?
While vaccines are proving to be safe and effective, there are still some Canadians who can’t — or won’t — get a jab.
Canadians under 12 still don’t have an approved vaccine available to them. While clinical trials for the age group are underway, Pfizer says the results aren’t expected until late September or even October.
Still, Miller said this doesn’t put a massive wrench in the plans to get back to normal.
“From what we’ve seen so far, children under 12 are an extremely low individual risk. So I think it’s highly unlikely that any infections that happen in that demographic are likely to put substantial pressure on the hospital system,” he explained.
Adults who are choosing not to get vaccinated, however, can be at risk. Depending on how many Canadians opt not to get the vaccine, that could translate into increased hospitalizations and, as a result, tightened restrictions once again.
Luckily, the portion of Canadians who are vaccine-hesitant is fairly small.
An Ipsos poll conducted exclusively for Global News in mid-June found 82 per cent of the 1,000 adults surveyed have either already been vaccinated or are awaiting their appointment. That suggests the vaccine-hesitant could be less than 20 per cent of the population, which lowers the risk of another lockdown.
“This is largely going to be shifting to a disease of the unvaccinated, rather than the vaccinated,” said Bogoch.
“Of course, the vaccinated people can still get ill, but it’s just going to pale in comparison … to the unvaccinated based on the emerging data that’s coming from other countries.”
America’s top infectious disease expert told NBC’s Meet the Press on Sunday that about 99.2 per cent of recent COVID-19 deaths in the United States involved unvaccinated people.
“It’s really sad and tragic that most all of these are avoidable and preventable,” Dr. Anthony Fauci said.
Still, Bogoch said he doesn’t expect the outbreaks among the unvaccinated to hit Canadian hospitals hard enough to force another lockdown.
“We will see a rise in hospitalizations as restrictions ease. But it’ll probably be in an unvaccinated population. Is that enough for us to have to lock down again? I really doubt it,” Bogoch said.
“But,” he warned, “it’s hard to speak with any degree of confidence in the COVID era.”
Is a true return to normal possible?
While there are still some unknowns that could trip up Canadians in this final sprint towards a return to normalcy, the experts were unanimous about one thing: back to normal is coming.
“This is something that we’ll be able to learn to live with,” said Miller.
One of the main hurdles as Canadians look ahead to crowded bars and brushing up against strangers is the mindset shift that needs to start taking place, according to Chakrabarti.
“The whole last year-and-a-half we’ve been hearing that if you get COVID, you’re going to die. And that’s very hard to undo,” he said.
But with vaccines cutting the claws off the deadly virus for most Canadians, the time is rapidly approaching to step back into normal society — and into one another’s bubbles, Chakrabarti said.
“Full vaccination protects you against a virus way better than a mask ever could,” he explained.
Canada shouldn’t be trying to stop every case of COVID-19, according to Chakrabarti, “because we don’t need to, as the virus has been defanged with the vaccine.”
“We expect there to be cases. We expect there to be outbreaks among unvaccinated people and we will do what we’ve always done: address those in a focused way through public health measures,” he said.
“This whole pairing in our minds of cases and lockdown now needs to be kind of decoupled, because that’s not the situation anymore.”
Bogoch agreed that a full return to normal “absolutely will happen.”
“We will have 20,000 people in a stadium for a concert or a sporting event. We’ll be sitting on top of each other, spilling beer on each other’s laps, singing along to our favourite musicians. We’ll be packed into bars and restaurants and nightclubs,” Bogoch said.
“This is going to happen.”