B.C. is no longer a model for COVID-19 prevention — and getting back to that stage is not guaranteed

The months when British Columbia could pat itself on the back for dealing with COVID-19 better than nearly any other place in Canada or the entirety of the United States have come to an end.

In the past month, the number of daily active cases in the province has quadrupled from about 10 a day to more than 40. The number of active cases has more than doubled, reaching levels not seen since May. Outbreaks are now widespread enough to require the self-isolation of more than 1,500 British Columbians. There are now more active cases per capita in B.C. than Ontario. 

In other words, it's not good. 

"The province, back in June and July, was right on the knife edge," said Daniel Coombs, a University of British Columbia mathematician who has been helping the provincial government with its modelling for COVID-19 since the outbreak began.

"It turned out that it didn't take much of a spark ... to ignite a fire." 

There remains the possibility B.C. can avoid the type of widespread second outbreak recently seen in many American states. But the rapid increase over the last month is cause for concern — and there's little certainty getting back to the five to 15 daily cases seen in May and June can be attained.

It's young people

The provincial increase over the last month is overwhelmingly concentrated in young people — of the 893 COVID-19 cases recorded in B.C. between July 6 and Aug. 6, two-thirds have been in people under the age of 40. The majority are in their 20s.

By contrast, less than 12 per cent of cases in the last month have been in people over the age of 60.

"'COVID fatigue' does play a role, particularly in things like long weekends where people are just wishing this would be over," said UBC psychiatry professor Steven Taylor, who specializes in the psychology of pandemics. 

"They hear the numbers are down. And so they get out in mass gatherings, and that's where they're infecting one another."

These outbreaks are much more difficult to handle than previous ones in B.C., because unlike those inside care homes or industrial plants, private parties make it difficult for contact tracers to find everyone before transmission takes off in the community.

"People go to a party and they might know half the people there, but there's going to be people that you don't know," said Coombs. 

It's true that nobody under the age of 40 has died from the coronavirus in B.C. — hence the reason deaths have slowed in the province even as active cases have doubled. But, at the same time, younger people can spread the virus before realizing they have it, and can also develop serious health issues of their own.

"The messaging needs to get out [that] this isn't an old person's disease," said Taylor. 

"The disease doesn't discriminate … and if [young people] get sick, it could get very bad."

Masks and schools

As cases spike among young people, the weekly average of people over the age of 50 getting COVID-19 has not been increasing.

That's a sign, said Coombs, that a large portion of British Columbians are continuing to buy into physical distancing guidelines and avoid large crowds, public health measures which he thinks might be enough to limit further daily growth.

And Taylor said the increase in cases has likely raised anxiety levels enough that there would be significant buy-in for further efforts to control COVID's spread."If there is a significant second spike, then, I would expect the genie would go back into the bottle very quickly," he said.

Perhaps. But as the final month of summer approaches, two other decisions could quickly approach for the government.

One is whether there should be further rules on masks, adding to the transit requirements put in place across much of B.C. this week. The other will be whether the province's current approach to reopening schools in September should be modified. 

"I've been saying this since the beginning of the pandemic … with the possible exception of May or June," said Coombs.

"We're entering a critical two weeks."