As provinces across Canada start to lift COVID-19 restrictions, some experts are questioning whether public health decisions are being made based on medical data or politics.
Ontario’s three-phase reopening plan that stretches into mid-March is underway, with proof of vaccination and masking to remain in place as capacity limits widen and more businesses reopen.
But Saskatchewan and Alberta are aiming to end all COVID-19 restrictions.
Is it too early to lift COVID-19 restrictions?
Epidemiologist Timothy Sly says even though the COVID-19 pandemic has taken its toll on the mental health and lives of Canadians, it’s still not reasonable enough to ignore scientific evidence.
“Hospital rates, ICU rates, wastewater rates, if they’re going down and they have been for the last three weeks, then we can look forward to taking a few more steps (in lifting restrictions),” said Sly.
But in the Prairies, the hospitalizations have only just started to decline.
“If politics chooses not to listen to that, then I think we’re a little nervous,” said Sly.
As of Tuesday, there were 1,623 people in hospital with COVID-19, according to Alberta Health, with 129 in intensive care.
Dr. Noel Gibney, professor emeritus in the department of critical care medicine at the University of Alberta, said the removal of COVID-19 restrictions is premature.
“If we look back at some of the previous waves, the government used hospitalization numbers of 400 or 500 to make decisions about what public health measures would be added or removed,” Gibney explained on Wednesday in an interview with Global News.
“We’re actually significantly above those numbers now, and our system remains under profound pressure.”
Why are some provinces removing restrictions?
On Tuesday, Saskatchewan was the first province to announce it would be ending the use of COVID-19 vaccine passports beginning on Feb. 14, with facemasks in indoor public settings to lift by end of February.
“Proof of vaccination has been an effective policy, but its effectiveness has run its course,” said Saskatchewan Premier Scott Moe on Tuesday.
“The benefits no longer outweigh the costs. It’s time to heal the divisions over vaccination in our families, in our communities and in our province. It’s time for proof of vaccination requirements to end,” he added.
Alberta then followed by announcing its COVID-19 vaccine passport program would end first thing Wednesday. Almost all public health restrictions would be lifted by March 1 — including masking — if hospitalizations continue to improve.
At a news conference, Alberta Premier Jason Kenney said Tuesday that while the restrictions exemption program (REP) served its purpose of increasing vaccination rates, it is no longer an effective tool for doing so and no longer needed, especially with so many vaccinated people still contracting the highly-transmissible Omicron variant of COVID-19.
Ontario’s health minister Christine Elliot said on Wednesday that the province is “not in the clear” to remove COVID-19 vaccine passports that are required to enter some indoor public settings such as gyms and restaurants or to drop the mask mandate.
“We have no plans, currently, to drop the passport vaccination situation or masking,” Elliot said. “We always said that we were going to take a very cautious, phased, prudent approach to opening up and that’s the path that we’re going to follow.”
On Wednesday, Ontario reported another drop in hospitalizations, with 2,059 people with COVID in hospitals and 449 in intensive care units. This is down from a week ago at 2,939 hospitalizations with 555 in ICU. Case counts, test positivity and wastewater signal have also been on the downward trend, Elliott said.
A political decision?
A clinical professor in the School of Population & Public Health at the University of British Columbia, Dr. Hoption Cann, said ending COVID-19 restrictions is a “political decision.”
He also said there are both scientific and economic issues for politicians to look at and try to balance.
“Economically, there’s been a lot of harm due to lockdowns during the pandemic. So as a politician, they kind of have to balance the two things. And it’s not an easy balance to make,” Cann said.
As provinces ease restrictions, he believes that potentially the number of infections could go up again, but it’s hard to predict at this time.
“What we do know is having two doses and particularly three doses offers very good protection against being hospitalized or dying from this infection. So an easing up of restrictions is one thing, but you still have to try and promote those people to get a triple dose or get vaccinated if they haven’t been,” said Cann.
With some provinces moving faster than others, Sly says provinces need to respond thoughtfully based on the data they have, like the number of hospitalizations and new cases, and not rush to remove all of the COVID-19 mandates on a single date.
'Evidence-based decision making' is key
“We need to look at the local situation and say, how are we responding sensibly and responsibly or are we just having a knee-jerk reaction due to some ideology,” said Sly.
Sly also acknowledged that there are many sides to the discussions that aren’t just based on epidemiology, stating that “we cannot have a future dictated by a scientist without any regard at all to the fallout.”
“We need a roundtable discussion. But when we have policies that seem to be made (because a political party) is looking for the popular vote or not really listening to what’s being said, then it is a little too soon to ease restrictions,” said Sly. “Evidence-based decision-making is the key here.”
Learning to 'live with COVID'
When Alberta Premier Jason Kenney announced plans to lift COVID-19 restrictions in phases on Tuesday, he said, “It’s time for us to learn to live with COVID-19,” listing the challenges of the pandemic: disrupting livelihoods, dividing people and hurting mental health.
In late January, Ontario Premier Doug Ford also said the province needs to “learn to live with” COVID-19.
Beginning on Jan. 31, social gatherings were increased to a maximum of 10 people indoors, and 25 outdoors.
Restaurants, bars, retail stores, malls, gyms, cinemas and other indoor public settings were also allowed to open to a 50 per cent capacity.
The province is planning to lift more measures on Feb 21, and again on March 14.One of the first countries to choose to “live with COVID” is Denmark, which is now seeing a record number of hospitalizations.
Although ICU numbers remain low, the country is registering a similar number of COVID-19 deaths as in previous waves of the pandemic.
“If we make a wrong move and because it’s politically expedient to do so, we could be rewarded by a sudden surge of cases again, mainly among the unvaccinated,” said Sly.
— with files from Jamie Mauracher, Kaylen Small, and Gabby Rodrigues
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