Cases are rising across western Canada. Does that mean the return of COVID-19 lockdowns this fall?

As kids head back to classrooms and some companies look at bringing employees back into offices, the delta-driven fourth wave of the pandemic has continued to grow, with case numbers rising sharply across western Canada. 

In some areas, they've reached levels that prompted public-health restrictions during the second and third wave, raising the question of whether fall will bring yet another lockdown or set of stringent public health measures across the country. 

But Canada's vaccination rate means this fall is different from fall of 2020, says Nazeem Muhajarine, professor of community health and epidemiology in the College of Medicine at the University of Saskatchewan in Saskatoon.

"I don't think that we would be hurrying to issue a stay-at-home order in our provinces," Muhajarine told Brian Goldman, host of White Coat Black Art and The Dose. 

Instead, Muhajarine anticipates a more focused strategy for public health measures this fall, including a regional approach to mandatory mask wearing, social distancing, and proof-of-vaccination documents in areas where COVID-19 numbers are high. 

"I think we will address the flare-ups that are happening in particular places as needed," he said.

"We have to have these measures happening where the background COVID prevalence or COVID rates are higher than in other places." 

However, as cases rise, some are concerned that those focused measures won't happen fast enough to keep schools and workplaces safe and avoid overwhelming the health-care system.

Muhajarine, who is also a member of the federal government's newly formed research network focusing on variants of concern, says travel within Canada adds a complicating factor.

"No city, no place is an island," he said. "We have to make sure that we issue caution for people who are travelling between cities, particularly between high incidence, high prevalence COVID-19 places to lower incidence and lower prevalence COVID-19 places." 

Need to do more to keep kids safe

One factor that would help, says Muhajarine, is more rapid testing in Canada. Countries like Denmark and the U.K., he says, have done a better job of making rapid tests that people can self-administer widely available. 

"We haven't figured that out in our country," he said. "We are just now ... setting up to pilot rapid testing in schools. We should have done this back in September [2020]. I think that testing capacity, particularly rapid testing capacity, has been really wanting in Canada." 

Young children who can't yet be vaccinated are a serious concern for Muhajarine. 

"We need to keep our children — who are going back to school unvaccinated, therefore unprotected in congregate settings for long periods of time — safe," he said.

"My fear is that this fourth wave will turn out to be a wave that disproportionately affects our children and youth."

He hopes to see children younger than 12 able to receive vaccinations by the end of this year or early 2022.

"That can't come soon enough," he said. "We don't know much about long COVID. That is another issue that we have to contend with. Children might get long COVID. And so we really have to do a lot more this fall to keep our populations, our kids safe." 

Muhajarine doesn't see enough of that happening yet. 

"In Canada two provinces, Saskatchewan and Alberta, have really no public health measures this fall," he said. "The public health measures were lifted in July, just sort of preceding the beginning of a fourth wave. As a matter of fact, the fourth wave might have been caused or hastened by the lifting of the public health measures."

Alberta ER doctor describes 'crisis'

Muhajarine urges public health leaders to revisit these measures as we head into fall. 

"Our public health leaders and our political leaders have to take courage and have to address this issue of not having enough public health measures to keep people safe." 

Dr. Shazma Mithani, an emergency room physician in Edmonton, agrees that COVID-19 protection measures are needed, but says the government in that province isn't taking the necessary steps to avoid a crisis this fall. 

Mithani is concerned about a "lack of leadership" at the provincial level when it comes to re-introducing protective measures to help mitigate the spread. 

"It's very clear that what is happening right now is just not sustainable," she said. "We're in a situation in the hospitals where the cases are coming in rapidly. We're in a staffing crisis."

Although Edmonton city council voted this week to re-introduce a mask mandate in that city, Mithani says a provincial mask mandate is needed. Lower vaccination rates in some rural parts of Alberta, she says, are translating to high test positivity rates in those areas.  

Mithani wants to see the provincial government bring in a vaccine passport system for non-essential activities. British Columbia, Quebec, Manitoba and Ontario have confirmed they will bring such a system in the coming weeks. 

She also says the province should consider limitations on indoor gatherings as activities shift indoors this fall. 

"Other provinces are doing it. And we haven't heard anything from our leaders," she said. "Measures definitely need to be put in place right now."

CBC has contacted the government of Alberta's Ministry of Health for comment, but has not yet heard back. 

Written by Rachel Sanders. Produced by Rachel Sanders and Amina Zafar.