Q&A: Dr. Janice Fitzgerald on new variants, vaccines and life with COVID-19

Since the onset of the COVID-19 pandemic in March 2020, Newfoundland and Labrador's Chief Medical Officer of Health Dr. Janice Fitzgerald has been at the forefront of the province's response. 

As the public returns to everyday life with COVID-19 more than two years later, vaccines are widely available, and many measures have been relaxed or lifted altogether. However, Fitzgerald says while the public may have largely settled into life with COVID-19, we must remain vigilant.

Fitzgerald recently spoke to the CBC's Leigh Anne Power about the province's current COVID-19 circumstances.

This interview has been edited for length and clarity.

Q: When the pandemic began, even one death was alarming. Now we're seeing three or four deaths a week, and it's very quiet. Why do you think that is?

A: The nature, unfortunately, of what's happened with COVID is that, you know, it has become quite a highly transmissible virus, and [it's] very difficult to put measures in place to control that, whereas previously, we were able to do that.

Unfortunately, when we see that kind of spread, much as we would with influenza for example, then the more people we will see with severe disease, and unfortunately, sometimes people will succumb to that.

We no longer test the way we did last year, either. So how do we know how much COVID is actually in our communities?

We are still doing some testing. Certainly, you know, in hospitals, in emergencies, if people are presenting and they're unwell, we are still doing some testing in that regard. People are doing their own testing, you know, with the rapid tests, and some people are reporting that. As well, we have waste water [testing], so that gives us some insight into what's happening. 

There are a few other things we look at, like the number of people who are actually in hospital with COVID, not necessarily because of COVID, the number of staff who might be isolating because of COVID, those all give us information. They are, generally speaking, a reflection of what's happening in the community. Over time, we can correlate that with what we think is actually happening in the communities.

So what's happening in the communities?

We certainly are seeing a little bit of an uptick in the last little while. Not unexpected, you know, as people start to move indoors, schools are back in session. So we are seeing a slight uptick in the number of cases that we have.

Certainly anecdotally, I'm sure people are aware of cases circulating around them, but that's, you know, not unexpected, and not out of keeping with what's being seen elsewhere. 

Some people are saying that if they test positive on a rapid test, they are still going to work or school, or they're travelling even positive, because they say the guidelines are sort of vague now. What do you say to those people?

We are still quite clear that if you are, you know, if you are positive and you are unwell, you should be staying home until your symptoms are resolving, and certainly until your fever has resolved for 24 hours. 

We know that during that time, If you're quite unwell and you have a fever and significant symptoms that are, you know, making you feel pretty miserable, that's sort of the most infectious time.… We would certainly want people to stay out of the workplace in that situation, and to, you know, stay at home, basically. 

And then, we're still saying that for 10 days from the onset of your symptoms, you need to be wearing a mask. That will reduce the risk of spread, especially in those, you know, on the end of the infection, when you may not be quite as infectious but still infectious, to some degree. 

There are a lot of reports right now that there's an Omicron variant that's heading this way over the winter. It's more able to evade our immunity. What can you tell us about that?

Right now, what we're seeing with this variant is that some of the medications that we use to treat it may not be quite as effective, because those are immune-based medications. So we are seeing that. It's something that we are watching closely, and we'll be keeping track of.

We've proven ourselves that wearing the mask not only helps [protect against] COVID, but it helps protect against the flu and other respiratory illnesses as well. So if we're looking at a flu season, which we're seeing in Australia as being fairly bad this year, and there's another strain of COVID coming, what would it take to bring back measures like masking and distancing, at least for the winter?

We'd have to show that there was significant impact to our health system, No. 1. And certainly, we'd have to, you know, have exhausted all other measures. These recommendations that we're making about masking, they may be stronger recommendations.

We certainly know that, you know, it's been two, two and a half very hard years. Our goal is to try to manage this as best we can, without having to go back to those, you know, really restrictive measures that we've had in the past.

We're looking at vaccines now for the fall. Some people were waiting for the fourth shot or their second booster to head further into the fall season to keep their immunity topped up as long as they can. What's the current advice on vaccines, and what we should be taking, considering the new variants?

We certainly are recommending that people get their fall booster of vaccine. Our recommendation is that you get a bivalent vaccine.

There are two bivalent vaccines that are available. There's a Moderna product and a Pfizer product. Both of them have protection against Omicron. So the bivalent refers to the fact that they have the original strain of COVID in there, as well as the bivalent strain, so protection against both. They're slightly different, but we are still recommending that people get the first bivalent that is available to them. 

One is against the original strain of Omicron, and then the other is against the BA.4 [and] 5. Right now there's no evidence to prove that one is, you know, superior to the other. So we are recommending that people get a bivalent vaccine.

AUDIO | Dr. Janice Fitzgerald talks about what's next for N.L. as COVID cases rise

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