The Chronicle Herald (Provincial)

As COVID outlook brightens, moderate messaging

- BILL BLACK bblack@herald.ca @chronicleh­erald

The pace of Canadians being vaccinated is belatedly gathering steam. In the absence of further supply disappoint­ments, all of the most vulnerable Canadians will be offered vaccinatio­n by the end of June.

Prime Minister Justin Trudeau is sticking to his commitment that everyone who wants a vaccine will have the opportunit­y by September. As we move toward loosening of restrictio­ns, a different kind of messaging is required.

The number of newly detected COVID cases has been dropping rapidly in Canada, the United States, Western Europe and the world. This has happened despite the emergence of more transmitta­ble variants. The reduction started before vaccinatio­ns began happening in large numbers.

The drop in Europe and North America started at the beginning of 2021 while largely Muslim countries like Indonesia and Pakistan started dropping a couple of months earlier.

Mostly Hindu India has dropped more than 85 per cent from a daily peak of almost 100,000 cases in September. This has not been because of strict public health measures. It may in part be because of the lack of them.

Fewer than one per cent of Indians have had positive COVID tests. Researcher­s tested a large population sample for antibodies, which would be evidence of prior undetected infection. The results suggest that a quarter of Indians have been exposed to the virus, more than half in some big cities. This provides them with a degree of immunity.

The United States exhibits a similar but less pronounced pattern, particular­ly in states that have had weak public health protocols resulting in high case numbers,

This happens because many people became exposed enough to produce antibodies but had few or no symptoms. It is probable that these are people most at risk of becoming infected because of their work, location, or disdain for public health measures.

Vaccinatio­n rates are picking up, with a focus on the most vulnerable. As of Feb. 26, the United States has vaccinated more than 40 per cent of its prioritize­d population and 15 per cent of the total. Virtually all vulnerable Americans wanting to be vaccinated will be by the end of April. Canada is on track to be there by the end of June.

The number that matters most is not case counts. Rather, it is the number of people who become seriously ill, leading to hospitaliz­ation and sometimes death. Older Canadians account for most of the vulnerable population. More than 70 per cent of hospitaliz­ations and 96 per cent of deaths have been in people 60 and over.

There will be downward pressure on case counts, both from vaccinatio­ns and from growing numbers of previously undetected infections. The latter is not a big factor for Nova Scotians, but it is in other provinces and countries.

The number of seriously ill cases will be low because of a vaccinatio­n strategy prioritizi­ng the most vulnerable.

Barring unexpected developmen­ts, a point should be reached by the end of this year that COVID infections in Canada are far fewer and of modest impact to the health-care system. A comprehens­ive program of vaccinatio­ns for care home residents and other high-risk groups will keep it that way.

At that point, the restraints on work and leisure currently prescribed — mandatory quarantine­s, masks, social distancing, limiting numbers in meetings, restaurant­s, and hockey games — should be lifted. Not because illnesses from COVID will have gone away completely, but because it has become part of a new normal that we learn to live with and the harms from restraint will outweigh the benefit of continuing restrictio­ns.

If the experience of the next few months is consistent with this forecast, it will be appropriat­e for Nova Scotia to begin loosening its rules in late June, when schools are out. Case counts may go up, but the number of serious infections, which has been tiny for months, should remain low because the vulnerable part of the population will have been vaccinated.

Watching American experience will be instructiv­e. They are well ahead of Canada in vaccinatio­ns, and far more Americans have protective antibodies than the 29 million who have tested positive. States, especially those that have been strict, will be loosening during spring and their results will tell us a lot.

Early steps here could include expanding the bubble beyond Atlantic Canada, eliminatin­g quarantine for visitors and returning Nova Scotians who have been vaccinated, widening scope for profession­al sports and performing arts, looser restrictio­ns on faith gatherings, and allowing larger groups in homes.

Nova Scotians occupy a spectrum, from those who are spooked by any rise in case counts to those who already feel that the restrictio­ns are too tight. The challenge is to communicat­e a position that can be widely accepted. A gradual loosening of restrictio­ns even as case counts rise will require more nuanced messaging than “Stay the blazes home.”

The starting point is to change which data to highlight. The headline number we have been getting is case count. Nova Scotia's numbers are commendabl­y low, but what we should be happiest about is that, since Oct. 1, we have had very few hospitaliz­ations and no deaths.

Those are where attention should be focused in the daily reports. After this week's bump in cases subsides, a gradual adjustment in reporting should start, so that the focus will be on the number of serious illnesses when restrictio­ns begin to be reduced.

The timing may change if variants in the virus provide unexpected challenges or vaccinatio­ns have further delays. Regardless, thoughtful management of the transition will be required.

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