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https://nationalpost.com/opinion/opinion-draconian-covid-measures-were-a-mistake-lets-not-repeat-them
Opinion: Draconian COVID measures were a mistake, let's not repeat them
It is time to accept that the virus cannot be stopped and will continue
to evolve
Author of the article:Drs. Neil Rau, Pooya Kazemi, Martha Fulford, and
Jennifer Grant, Special to National Post
Publishing date:Sep 14, 2022 • 1 day ago • 5 minute read • 960 Comments
A sign in a barber shop window indicated the establishment was closed
because of COVID-19 in Ottawa, Wednesday, March 18, 2020. THE CANADIAN PRESS/Adrian Wyld ORG XMIT: 22949852
A sign in a barber shop window indicated the establishment was closed
because of COVID-19 in Ottawa, Wednesday, March 18, 2020. THE CANADIAN PRESS/Adrian Wyld ORG XMIT: 22949852
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Almost two years ago, community measures including lockdowns to suppress
COVID transmission had widespread support, with a movement (“COVID
Zero”) that promoted more draconian measures, hoping to eliminate COVID altogether. Schools, institutions of higher learning and businesses were shuttered. Even playgrounds and outdoor washrooms were closed, and
youths simply enjoying outdoor summer parties were vilified. Most of
these measures were ineffective, many were harmful. Has anything been
learned from these mistakes or will they be repeated the next time case
counts go up? We have some thoughts for the future.
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It is time to accept that COVID-19 cannot be stopped and will continue
to evolve. Full faith was first placed in the vaccine, and then in
boosters as “our way out of the pandemic.” However, the vaccines don’t stop infections of transmission as much as originally hoped — nor do boosters. The COVID Zero movement is dead, and many early proponents
have recanted. It is impossible to stop a virus that spreads before
symptoms appear, and with super-spreader events that can infect most
people in a room.
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The other challenge is that COVID reinvents itself quickly. As one
strain transmits through the community, population immunity emerges and
the next strain is selected to keep itself going — this is viral
evolution. It’s like the iPhone: when the market gets saturated with the latest version, a new one is released to fill the void. Right now, the
variant with the longest run has been Omicron, with its relatives
(BA.4/5) now in circulation. How long the Omicron run will last is
anyone’s guess: more Omicron variants, or a completely new variant could
take over soon. How long before the newly released bivalent vaccine,
targeting the original COVID and Omicron strains, is also out of date?
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Additional vaccine doses should be tailored to the specific
circumstances of the person, not a “one-size-fits-all” solution. One
thing has remained constant since the pandemic began: the young and
healthy under age 50 seldom have severe outcomes from COVID-19, so
guidance on vaccination should be tailored to age, immunity and risk
factors. While a very small number of people remain vulnerable, either
prior infection, or vaccines received many months ago still prevent
serious outcomes for almost everyone — that’s what matters most to
protect the health-care system. Even our higher risk elderly are seeing
disease that is less severe than what we see with other common viruses, including other coronaviruses. The mortality rate for those in elder
care homes was eight per cent with other (non-COVID) coronaviruses,
similar to what we see with COVID now.
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Likewise, it is folly to believe that more vaccination uptake (adult
rates in Canada are at 91 per cent for two doses), or that more booster
doses of the latest bivalent vaccine will stop transmission or the
emergence of new variants. This is because vaccine protection for
infection falls off (wanes) within a few months following a dose.
Consider the latest NACI guidance regarding boosters being needed every
three or six months: Dosing this frequently is unlikely to further lower hospitalizations and will be very hard to accomplish — coverage rates of third and fourth doses for those under age 40 are well below 50 per cent
and five per cent respectively. As discussed in a recent New England
Journal of Medicine article, it is also impractical to give boosters
more than once a year. While it is tempting to blame new variants on low vaccine uptake, this causal link is far from clear. Evolutionary
dynamics, especially with fast-mutating coronaviruses, make the
emergence of new variants inevitable, regardless of vaccination rates.
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There’s a bigger picture issue here: in 2020, COVID had a more
significant health-care system surge impact than other respiratory
viruses. By 2022, with significant population natural immunity, vaccine immunity, or both this is no longer the case. Our health-care system is currently strained for various reasons unrelated to COVID.
Testing and isolating everyone is neither sustainable nor necessary. The brouhaha over Ontario’s latest guidance to no longer require five days
of isolation for those who test positive is unjustified. With Omicron,
close to 60 per cent of infected people have no symptoms, and not
everyone with symptoms gets tested. Testing, especially PCR testing,
continues to detect virus segments for weeks after the virus is dead.
Keeping people at home after their symptoms have resolved, or even when
they do not have symptoms, will not stop ongoing circulation of the
virus, nor will it protect people from the majority of cases that are unsuspected. Testing less doesn’t hide the problem: we can still
estimate COVID-19 by testing wastewater and those with symptoms. It’s
similar to political polling — we don’t call everyone, but we still get
a good idea of party popularity.
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In general, testing should be limited to people who might benefit from
drug treatments, or if there is confusion about the cause of illness to
allow more targeted care.
Remaining vaccine passports, such as for attending university and
visiting hospitals, as well as workplace policies need to be retired.
Even before vaccine mandates and passports were introduced, vaccination
rates were well over 80 per cent. Of course, there were those who, for
whatever reason, chose not to get vaccinated. Passports infringed on the principle of informed consent, the most basic tenet of which is the lack
of coercion, yet did little to dramatically increase vaccine uptake.
They also did little or nothing to stop transmission, polarized our
society, and punished many low-income people in front facing jobs, many
of whom were infected before everyone else. Health-care workers who
refused vaccination were lost.
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These folks are needed now more than ever, whatever decision they made.
While most of the government vaccine mandates are gone, burdensome and inconsistently applied testing mechanisms at Canada’s borders have done nothing to reduce importation or transmission of COVID. In the current
era, there is no remaining justification for “othering” the unvaccinated nor need to test the unvaccinated more so than the vaccinated. Some with limited access to vaccination in developing countries who wish to come
to Canada to work are still subjected to needless quarantine and
testing. ArriveCAN is an international embarrassment, and Canada can do
better.
In summary, errors were made in the “pandemic fog of war.” There is now
a chance to correct them and to change our course for the better.
Dr. Neil Rau is an infectious-diseases physician and medical
microbiologist in Toronto, Dr. Pooya Kazemi is an anesthesiologist in
Victoria, Dr. Martha Fulford is an adult and pediatric infectious
disease physician in Hamilton, and Dr. Jennifer Grant is an infectious
disease physician in Vancouver.
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