Omicron spread puts Alberta at critical point in fight against COVID-19, experts say

Record case numbers show Alberta is at a critical point in the battle against COVID-19 while public health experts warn that the danger of Omicron infections must not be underplayed.

The highly contagious variant is spreading like wildfire in the province.

On Thursday, Alberta reported its highest ever single-day increase in new COVID-19 infections, with 4,000 new cases. 

The case numbers shattered the previous daily of record of 2,775, reported Wednesday.

Across the province, the test positivity rate is hovering around 30 per cent, the highest it has been since the start of the pandemic almost 22 months ago.

The active case count more than doubled in less than a week, the province said. On Dec. 23, Alberta's active case count stood at 8,359. By Dec. 28 it was almost 17,400.

As of Thursday, 371 Albertans were in hospital with COVID-19, including 48 in intensive care.

A total of 7,025 Omicron cases have been reported in the province.

Alberta is among a growing number of jurisdictions cutting back on PCR testing as Omicron threatens to overwhelm lab capacity, limiting the province's ability to accurately track the spread of COVID-19.

Missing numbers

The high positivity rate suggests the province is already missing a significant number of cases, said Dr. James Talbot, Alberta's former chief medical officer of health.

He fears the health-care system will again be pushed to the breaking point.

The record case numbers are "very serious," Talbot said Thursday. "It's a huge increase in a very short period of time. And it is, obviously, not all of the cases."

The province should have already adopted more stringent public health measures to tamper down on Omicron, Talbot said.

Large public gatherings, along with open classrooms, could result in super-spreader events, he said. Alberta needs to ramp up targeted vaccinations for children, he said. 

"It's a very concerning state of affairs," Talbot said. "By not having the restrictions in place, Alberta is ensuring that we're going to go to quite high numbers before this is over."

Alberta is not alone. The Omicron variant continues to trigger record-breaking COVID-19 numbers across the country. 

Manitoba and British Columbia set new case records Wednesday. Ontario and Quebec both recorded new highs for new infections Thursday. 

"It was clear that the [Alberta] numbers are both high and incredibly undercounted," said Dr. Lynora Saxinger, an infectious diseases specialist with the University of Alberta.

Early data suggests Omicron spreads more easily than other variants and that it often results in milder infections, meaning fewer hospitalizations.

Saxinger said the severity of Omicron in medically vulnerable populations is still unclear. There is also a lack of data on the prevalence of long COVID among those infected, she said.

It's a very uneasy place right now, waiting to see which way this will go.-Dr. Lynora Saxinger

People need to take the variant seriously and not assume that an infection will be mild and brief, she said. Patients, especially those who are unvaccinated or medically vulnerable, may still face severe outcomes.

Hospitals should be bracing for the impact of a surge in cases, Saxinger said. 

"I'm not sure that the virus is less severe," she said. "I think that it's less severe so far, on a population basis, because of vaccination and prior infection. 

"It's a very uneasy place right now, waiting to see which way this will go."

'Tip of the iceberg'

The case numbers released Wednesday are only the tip of the iceberg, said Dr. Noel Gibney, professor emeritus at the University of Alberta school of medicine and a critical care specialist.

Gibney suspects thousands of cases are already undocumented and that the lack of accurate data could give people a false sense of security.

The positivity rate will likely surge to around 50 per cent within three weeks, Gibney said.

The province should be clamping down on large public gatherings, tightening masking regulations, and delaying the opening of schools to clamp down on the spread, he said.

Gibney expects the strain on Alberta hospitals will be acute. 

With community transmission reaching unprecedented rates, hundreds of front-line health-care workers could be forced into isolation, leaving an already strained system severely understaffed.

"We still have over 300,000 unimmunized people in the province, many of whom are older, many of whom have significant co-morbidities and may end up in hospital," Gibney said.

"Even if the hospitals aren't overwhelmed with COVID patients, it's going to be really difficult to provide care to the rest of the population." 

Omicron does offer a possible silver lining, Gibney said.

Alberta, and other jurisdictions across the country, could be provided a high level of herd immunity. Meanwhile, the milder mutations of Omicron suggest coronaviruses may also be less severe. 

"It is possible," Gibney said, "that Omicron is really the beginning of the end of the pandemic."