Canada is gearing up to reopen. Can it last?
Vaccines will help mitigate disaster, but provinces must avoid mistakes of the past
This is an excerpt from Second Opinion, a weekly roundup of health and medical science news emailed to subscribers every Saturday morning. If you haven't subscribed yet, you can do that by clicking here.
Much of Canada is on the verge of reopening again, with hard-hit provinces lifting lockdowns and mapping out a path to something vaguely resembling normal, while trying desperately to avoid making the mistakes of the past.
The latest advantage we have on our side is COVID-19 vaccines — the Get Out of Jail Free card that will help parts of the country that have been reluctant to impose strict public health measures mitigate another reopening disaster.
"Vaccines are going to blunt the damage of the rush to reopen, but I'd tend to go cautiously and stepwise," said Dr. David Fisman, an epidemiologist at the University of Toronto's Dalla Lana School of Public Health. "The single most important thing we can do right now is get people vaccinated."
But at what point will we have enough shots in arms to reopen restaurants, bars, gyms and other vital sectors of the economy that we once took for granted but now deem high risk?
That depends on who you ask — and where you live.
Canada sets sights high on reopening
Canada's Chief Public Health Officer Dr. Theresa Tam says provinces should only begin to lift public health restrictions once 75 per cent of adults have at least one vaccine dose and 20 per cent are fully vaccinated.
Yet that lofty goal hasn't actually been achieved anywhere else in the world.
In the U.S., less than 50 per cent of the population has at least one shot, but that hasn't stopped many states from reopening society and even allowing fully vaccinated Americans to stop wearing masks inside in most places.
In the United Kingdom, more than 70 per cent of adults have received a first dose and people are now not only allowed to meet up indoors for the first time in months, but also dine inside pubs and restaurants and even go to the movies.
And despite only recently achieving 60 per cent vaccinated with one dose, Israel began reopening its economy months ago allowing fully vaccinated people to visit restaurants, gyms, concerts and sporting events.
Yet while those countries may have had a jumpstart on Canada's vaccination campaign, we're gaining on them fast.
In just five weeks, Canada has doubled the number of shots in arms, up from 10 million in mid-April to more than 20 million as of Friday. Close to 50 per cent of Canadians have also received at least one shot so far — surpassing the U.S. this week on first doses per capita, despite having fewer fully vaccinated people.
But unlike those other countries, we've also been stuck at under five per cent fully vaccinated for months and have barely moved the needle on that front since shifting our strategy to prioritizing first shots.
Provinces poised to reopen
So is now the right time to reopen Canada? Or should our hardest-hit provinces wait to hit the federal government's threshold of 75-20?
"I do think we're going to be in a position for a substantial reopening soon because of vaccination," said Prof. Caroline Colijn, an infectious disease modeller at Simon Fraser University.
"It's not the same as it was before where you just sparked these huge numbers of new bushfires and you have to spend months putting them out, because as we vaccinate they will put themselves out — it's like rain falling all over them."
WATCH | How provinces are managing reopening expectations:
Saskatchewan became the first province to announce an ambitious reopening plan earlier this month that will allow bars, group fitness classes and indoor gatherings to start up again at the end of May, contingent on just 70 per cent of people over 40 with one dose.
Quebec is leading all provinces in its vaccination campaign, with more than 60 per cent of adults having received a first dose and roughly 15 per cent more with an appointment scheduled.
That has allowed the province, which has recorded more deaths per capita from COVID-19 than any other, to become the next to announce a detailed plan to reopen earlier this week.
While Quebec has succeeded in reducing the number of cases, hospitalizations and deaths in recent weeks, the pace of vaccination is what has allowed the province to commit to loosening measures.
On May 28, the province will finally lift the curfew in effect in some regions since January and then, in short succession, will allow restaurants and bars to reopen and many activities to resume.
Dr. Horacio Arruda, the province's public health director, put it this way: "Vaccinated in May, and then freedom, with caution, but freedom and hope for the summer."
WATCH | Quebec to start lifting COVID-19 restrictions May 28:
That's a far cry from other hard-hit provinces like Ontario, where much of the province has largely been under a strict stay-at-home order since Boxing Day despite a significant drop in the number of recent COVID-19 levels.
But Premier Doug Ford announced Thursday that there is light at the end of the tunnel, with outdoor activities permitted as of Saturday and things like patio dining returning the week of June 13 — when just 60 per cent of Ontarians are expected to have a first dose.
And while Alberta doesn't yet have an official reopening plan in place, it will allow K-12 students to return to in-class learning next week and fully vaccinated Albertans to skip quarantine if they are exposed to COVID-19 and are not showing symptoms.
"This is all uncharted terrain," said Dr. David Naylor, who led the federal inquiry into Canada's national response to the 2003 SARS epidemic and now co-chairs the federal government's COVID-19 immunity task force.
"I expect we are headed for another Canadian multi-jurisdictional experiment with reopening — both as to pace and form."
Canada must remain 'on guard' for variants
The caution with announcing reopening plans may be in part due to the disastrous attempt to lift lockdowns in February that prompted a devastating third wave in parts of Ontario, Alberta and Quebec due to the rapid spread of more contagious coronavirus variants.
But experts say that while the threat of variants of concern is still very present, new variants could also emerge with even more dire mutations — like the ability to escape immunity from vaccines.
"If we want reopening as soon as possible, we can do it and we can probably do it without threatening our healthcare system by doing it in a relaxed and careful way," said Colijn. "But if we want to be really sure we're not going to have a vaccine-escape variant that threatens our healthcare system in the fall, then we also need to be thinking about that."
Fisman says variants are a "curveball" that could jeopardize the success of our reopening strategy, adding that provinces should "go slowly" and "change one thing at a time, then reassess."
Colijn says as Canada reopens further we need to "be on guard" for new variants and stop them from entering the country if they emerge elsewhere in the world, adding we may need to act proactively before they arrive.
"We've got to get second doses out, because that will really help immunity against those emerging variants and we may have to get boosters out," she said.
"We really do need the population to understand that they may not need second doses immediately before they ever eat in a restaurant again, but they need them ... for getting back to normal life."
This is an excerpt from Second Opinion, a weekly roundup of health and medical science news emailed to subscribers every Saturday morning. If you haven't subscribed yet, you can do that by clicking here.
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With files from Ben Shingler
