`COVID-FLU double whammy' a concern with fall approaching, doctor warns
As the seasons change again this year, it's time for Round 3 of autumn as COVID-19 lurks.
Since COVID hit Alberta in March 2020, each fall has brought with it a substantial wave of new infections. Experts are warning to brace for increased transmission as in-person school and work resumes for many.
But there's also a lot different about autumn 2022. COVID vaccinations are available to more people than ever, but there are fewer public-health restrictions in effect than any other point in the pandemic.
Here's what you need to know about COVID as we head into the next season.
WHERE THE COVID SITUATION STANDS
Experts are still watching Alberta's hospitalizations and deaths due to COVID, as well as tracking the virus through wastewater sampling.
Alberta Health statistics current as of last Wednesday show 819 people in Alberta hospitalized with COVID. By comparison, at about the same time last year, the province announced a sweeping return of public-health restrictions as a rising fourth wave saw COVID hospitalizations climb to 877.
But ICU admissions due to COVID were a major concern at the time, with more than 250 patients needing intensive care, compared to just 26 now.
Public health physician Dr. Jia Hu said autumn has delivered COVID curveballs in the past.
“Last year, I thought we were in a pretty good spot, and then Omicron came around,” he said.
The Omicron variant, or BA.1, was first detected last November. Because it's so highly transmissible, it drove Alberta's most intense waves of COVID, and its subvariants BA.4 and BA.5 are now dominant in the province.
Hu said the challenge this year is likely to be the combination of COVID and the return of other respiratory viruses that have previously been suppressed by measures targeting COVID.
“Between all of these things put together, I just think there will be a lot of sick people,” he said. “A COVID -flu double whammy could really torpedo the health system.”
University of Alberta infectious disease specialist Dr. Lynora Saxinger added that, with some variation, there have been around five deaths per day due to COVID during the summer.
“I feel like that has receded from people's view — maybe a little too much,” she said.
Saxinger said it's especially important to test yourself and stay home if you're sick to avoid contributing to the spread. And even though it's no longer mandated, wearing a mask while in indoor public spaces can also help.
“We're going to be entering a period of what's probably going to be higher risk, and everyone should put their shields back in place and proceed.”
BOOSTER SHOTS AND BIVALENT VACCINES
Last fall, if you had two shots to protect against COVID, people called that “fully vaccinated.”
A year later, things are more complex. Booster shots beyond that initial series are now recommended, and the latest booster is a new bivalent shot targeting both Omicron and the original virus strain. Albertans 18 and older can start booking that vaccine starting Wednesday.
The MRNA vaccines against COVID work by giving your cells a blueprint to make a harmless replica of a spike protein found on the outside of the virus. The immune system encounters it and makes antibodies to destroy it, teaching the body to recognize and attack the virus in the event of a COVID infection.
But Omicron has so many mutations that changed the virus spike protein that it has been able to slip past defences more easily — hence the need for an updated booster.
Saxinger said the vaccines previously approved in Canada have proven incredibly effective. As the virus has shifted over time, the original vaccine isn't disarmed, but it has become less well matched to what's currently circulating.
Adults are eligible for the bivalent booster as long as it's been at least five months since their last vaccine or COVID infection. But eligibility for the fourth dose, or second booster, widened to anyone 18 and older in July.
People who got that shot in the summer will be waiting longer for the bivalent booster. But Saxinger said if you're in that camp, you weren't wrong to take the booster when you did.
“For anyone who's having buyer's remorse about their fourth dose, I think it will probably become clearer with more time how much the tweaking of the vaccine recipe does anything,” she said.
“But it's very clear that any boost, whether it's the original vaccine or the new vaccine, does provide a significant antibody level boost.”
The only bivalent vaccine currently approved in Canada is the Moderna Spikevax booster that targets BA.1. The U.S. has now approved vaccines that specifically target BA.4 and BA.5. According to Health Canada, clinical trial results of the BA.1 shot approved here have still been “found to generate a good immune response against the Omicron BA.4 and BA.5 subvariants, and is expected to extend the durability of protection.”
ALBERTA'S VACCINATION RATES
Slightly less than half of Albertans 18 and older have gotten at least one COVID booster beyond the first two shots, according to Health Canada data.
Those are the lowest numbers in the country, with every other province and territory topping 50 per cent booster coverage for adults, with some above 60 per cent.
Saxinger said two doses still offer protection, but data has shown that a third shot significantly bolsters those defences, especially against severe disease.
“If your last exposure, whether it was with a vaccine or through infection, was more than six months ago, it would be very good to prioritize getting your booster for the fall,” she said. “We don't have a crystal ball, but we think there will very likely be a potential surge (of COVID) because that's what happens with respiratory viruses in the fall.”
Hu hopes the end of summer, and the introduction of the latest booster, brings more people's attention back to updating their COVID protection.
“COVID is still a leading cause of death,” he said. “And getting a shot is keeping yourself healthy. Like eating well and exercise and all that — getting a vaccine is a hell of a lot easier than doing all those things we keep telling you to do.”