The Grey Bruce Public Health Unit. (Matt Hermiz/Bayshore Broadcasting)
Grey Bruce’s medical officer of health says the health unit may soon shift from a Covid containment strategy to managing outbreaks in high-risk settings, if Omicron spread is not controllable.
The active case load in Grey Bruce has surged to 187 and the number of high-risk contacts monitored by Public Health has surpassed 1,500 as infection rates increased in the region along with the rest of Ontario, Canada and many countries around the globe. Dr. Ian Arra says the Grey Bruce Health Unit will strive to keep case and contact tracing going, but with the elevated case numbers over the past week it may no longer be sustainable beyond a few more days.
“In that case, the strategy would be to move to managing outbreaks in high-risk settings,” Arra says. “Many health units moved to this strategy a long time ago instead of containment.”
Arra says while there’s only been lab confirmation of a single Omicron case in Grey Bruce thus far, the local epidemiology suggests there are likely more and if it’s not already, it will become the dominant strain based on all assessments.
He says the initial data from South Africa suggests Omicron is not as severe as the previous strain, but is more transmissible.
“Another point of data that might be helpful is the announcement from the chief medical officer of health last Friday that in the Ontario healthcare system there are only two cases in the ICU related to Omicron, which is very reassuring that it’s not as severe disease,” Arra explains. “The concern that comes from the science table and the chief medical officer of health is that it is highly transmissible and the vaccine is not as effective against it, so breakthroughs are going to happen and the number of people that might be infected could be very high.”
Arra says there’s no way to know ahead of time but if the vaccine is not as effective and Omicron is not controllable by case and contact tracing, one of the scenarios is it’s going to be circulating through the community. He says the fact that it’s not as severe disease, many people are going to be infected and recovered and there will be immunity there from it.
Grey Bruce’s medical officer of health acknowledges people are tired and fatigued, but he is urging the community to remain vigilant over the next few weeks. He says the Grey Bruce Health Unit is approaching this surge with strong recommendations and not orders or letters of instruction, as evidence from best practice in Public Health dictates if you put measures for people who are already compliant it backfires.
“You implement certain measures to what end?” Arra wonders. “That’s why we’re just asking people to be as vigilant as they can. If there is going to be ability to control this, that would be great. If it is not controllable and it’s going to go through (the community), it’s going to go through in a gradual way.”
“And for people who have not had their third dose,” continues Arra. “If they can get that dose, we know that the third dose will boost immunity compared to the second.”
Arra says it is inevitable Covid will be endemic as the criteria related to the characteristics of the virus is not met to eradicate it. He says the only question is at which rate will it will become endemic.
“Is it going to be fast enough to overwhelm our health system, or gradual through vaccines, effort and people being vigilant,” Arra says.
Arra reminds hospitalization rates and capacity in the healthcare system are the main reasons the pandemic has danger to it, and whether or not Omicron will pose a threat in this regard will become clearer in the weeks ahead.
“Knowing that Omicron has been circulating for two weeks, I would look over the coming two to four weeks and if there is no increase in hospitalizations that is significant, that will be very good news,” says Arra.
In Grey Bruce, there are currently four people hospitalized due to the virus. Across Ontario, intensive care unit admissions were reported at 164 on Monday. The Ontario government indicated in an early December news release the province is able to safely admit about 300 Covid patients to ICUs without putting at risk urgent surgeries.