New Brunswickers 'living with COVID' without the numbers they've grown used to

The government is asking New Brunswickers to manage their own risks for COVID-19 now that all Public Health measures have been lifted, but at the same time, it's providing less data about the virus to help them gauge that risk.

The COVID-19 dashboard will now be updated every Tuesday instead of daily for the rest of the month.

In April, it will be dropped altogether and COVID information will instead be shared weekly in the communicable disease section of the Public Health website.

Department of Health officials have not said whether all of the same data will still be available. But Dr. Jennifer Russell, chief medical officer of health, did say the department will "start to diminish the reporting … to more of a surveillance dashboard."

In addition, parents are no longer required to report if their children test positive to their school.

Ray Harris, a Fredericton-based data strategist, says "it's going to be very challenging" for people who have gotten used to judging their risk based on the daily hospitalizations and infections.

He thinks weekly updates are "a reasonable cadence to make informed decisions.

"But if that follows through and in April, it's pulled completely, then, you know, it's very hard to manage your own risk when you don't know what the risk is."

Russell said if people have somebody who's vulnerable in their household or social circle, such as someone with a compromised immune system or a chronic disease, then their risk continues to be high, and will be "in perpetuity" during a pandemic.

She encourages those people to continue masking indoors as much as possible when they're around people from outside their household.

"I think people are really confident in their ability to use all the tools in the toolkit that we've been providing throughout this pandemic. We've evolved so much with each and every surge, with each and every variant. We've learned so much, along with vaccination."

Raywat Deonandan, an epidemiologist and an associate professor at the University of Ottawa, questions the reason for doing away with the dashboard.

"Is it because they haven't got the resources to maintain it? All right. That's a reasonable argument to make. If that's the case, get more resources," he said.

"Or is it because they want to pretend the crisis is over, and 'what's the point of having daily reporting on something that doesn't matter anymore?'

"If it's the latter, that's not cool."

Deonandan said not only do citizens use the dashboard data to make individual choices in their lives, but scientists also rely on the public information.

"So what you're doing is disempowering that cadre of scientific investigators … which is never a good thing in light of a crisis that already divides people along the lines of trust," he said.

"We have a crisis of trust — trust in government, trust in authority, trust in scientists, trust in public health, et cetera. The way that you assuage distrust is to offer more information, not less."

So while Deonandan is sympathetic if the decision is driven by a lack of resources, he believes the "societally deleterious impacts" will outweigh any money saved.

Department of Health spokesperson Bruce Macfarlane has said part of transitioning to living with COVID-19 means "the reallocation of our time and resources to other Public Health priority areas." He did not elaborate or explain how dropping the daily dashboard will save time if the data will still be collected daily.

Hospitalizations rising

Harris, who started his own COVID dashboard a year ago, believes there's still a lot of coronavirus in the province.

He points to hospitalizations, which have "really picked up again" in recent weeks.

On Feb. 25, the day after the province announced it would be lifting all restrictions, 72 people were in hospital.

As of Friday, there were 103, including three youths 19 or under.

Of those, 49 were admitted for COVID-19, and 54 were initially admitted for something else when they tested positive for the virus.

"We know that hospitalizations have about a 10-day lag on cases, but now we don't really know much about cases," said Harris, because PCR (polymerase chain reaction lab) tests are reserved for certain priority groups and self-reported positive rapid tests don't count toward the active case count.

"It's just, I think, jumbled in there to try to get the real story out of it," he said.

"We don't know why [hospitalizations are] coming back because we don't really have a great case data."

The percent of people hospitalized for COVID versus with COVID has been consistently about half and half, said Harris. Roughly 50 people is "still a lot," he said.

Health-care workers off up

The number of health-care workers who are off the job isolating after testing positive for COVID has also increased in recent weeks.

When the decision to remove restrictions was announced, 408 were off across the province. As of Friday, that number stood at 577, including 332 from the Horizon Health Network (its highest total Harris has on record), 181 from Vitalité (down from a peak of 191 on March 7), and 64 from Extra-Mural and Ambulance New Brunswick (down from a peak of 90 on Feb. 22).

When hospitalizations started to trend down in mid-February, the number of infected health-care workers, "strangely," didn't go down with them, said Harris.

It suggests that in the community or in the hospital, there's still a big issue with COVID and contracting COVID and spreading COVID.- Ray Harris, data strategist

"I think we have to ask why isn't it moving and do we need to do more to protect health care workers — assuming that 500 health care workers out of the system has a negative impact on the hospital, which I think is, again, a reasonable assumption to make" since hospital capacity isn't only about available beds, but also people available to work.

He noted health-care workers are among those who get diagnostic PCR lab tests, not the less reliable rapid tests, and is "probably a reasonable indication of how much coronavirus there is in the community."

"It suggests that in the community or in the hospital, there's still a big issue with COVID and contracting COVID and spreading COVID."

Active cases 'incredibly high'

Active COVID cases are "incredibly high," according to Harris.

He thinks back to January 2021, when the peak was 348. We "blew past" that in September, reaching 370, and "never looked back," he said.

As of Friday, four of the health zones each had more than that — two of them more than double, and one more than triple — with the others not far behind. There were 4,055 active cases.

And again, that's with PCR tests being limited.

Less information about vaccination status

Harris doesn't agree with the way the government chose to represent the vaccination status of hospitalization, ICU and ventilator cases, and deaths.

The province defines "protected" as boosted or fully vaccinated less than six months. "Partial or no protection" refers to fully vaccinated more than six months, partially vaccinated, and unvaccinated.

At one point, fully vaccinated, partially vaccinated and unvaccinated were separated, but as vaccination rates started to climb, people started to see more people in hospital who were vaccinated than unvaccinated. "People were misinterpreting that as vaccines don't work. … And [the province] got into a real messaging problem."

Instead of educating people about how, when a higher proportion of the population is vaccinated, those numbers naturally rise, it's now "showing less information," he said.

Shifting focus over time

It's interesting how numbers have been the focus throughout the pandemic, but the focus has changed over time, Harris observed.

He started his dashboard in January 2021, as cases were really starting to pick up, partly to try to fill a gap. He wanted to see how active cases by zone were trending. Although the government's dashboard showed how many active cases there were in each zone, it didn't provide a daily breakdown.

Creating his own dashboard also helped him cope with the pandemic, he said.

"Having the knowledge of what was happening and having the ability to make decisions for myself, it just removed some of that uncertainty."

Harris started out posting images of his data on Twitter and as more people showed interest, he decided to make his site public.

"And they, I think, appreciated a second resource to be able to keep informed with it," he said. "It was just a way of sharing some of that comfort with others."

Later, the focus shifted to other trends, such as the breakdown of ages.

Last spring, it shifted again to vaccines and "the race towards the goals" set by the province for first and second doses.

"Not to be over dramatic about things but that pursuit of a vaccinated population … felt like one of the last times where, you know, everyone was together on something, everyone was kind of rowing the same direction," said Harris.

"A lot of us were, you know, counting the same things and trying to get to the same goal. And it felt good. There was a lot of camaraderie in that."

It was also "more fun to track" because everyone was "refreshing the numbers hopefully," to see how many people got their doses, "as opposed to dismally," to see how many died or were hospitalized.

In hindsight, that positivity between May and late July was "overly optimistic," said Harris. He and many others "thought that it was going to be, in fact, the welcome end to the pandemic."

Testing was the big story for a while — Were we testing enough? What was the positivity rate?

And then last fall, the data turned to hospitalizations and deaths.

'Big split' in community

It's been "grim," Harris said. "And then on top of that, you know everyone, I think, is just so tired of numbers and the pandemic in general."

That's when he noticed a "big split," he said. There are the people who were "promised that they would be able to move on with their lives, and they want to move on with their lives." 

There are those who still want to proceed with caution.

And between those groups there are "10 [to] 15 different camps of thought."

"It just seems like so many people have so many opinions on what to do, and there's so much fatigue out there, and there's so much dissatisfaction out there, that it's been — I just find it's been a really much more challenging conversation to be a part of over the last five months."

A simple social media post about the number of hospitalizations on a particular day might generate comments ranging from, "'Who cares?' to, 'I thought vaccinations were supposed to work,' to, 'We need to shut down the province five days ago.'"

After sinking about three weeks worth of work into his dashboard, which now has 8,500 rows of data, Harris has called it quits — at least for now.

When the government stopped updating its dashboard on weekends, it killed his trends data, he said.

But he believes other community reporting may emerge, and he has "some trust that if things get really bad again, we're going to see some government involvement."

He doesn't rule out the possibility of starting his dashboard up again.

He gave it up for about two weeks last summer, he said, "when we thought [COVID] was behind us at that time and … I'm skeptical that, you know, this won't be my last foray into the dashboard either."