The Dominance of Omicron

covid hot spot map of the world

Health experts have warned since omicron took over as the dominant strain that everyone is likely to get COVID-19 at some point. Yet all of the data we have at this point suggests there are still millions of Canadians who haven’t been infected.

How can it be that two years into a pandemic marked by increasingly contagious variants, so many people remain COVID-free? What separates those of us who have tested positive from those who haven’t?

mask, gloves, and headphones with a note saying "Keep calm and protect your friends"

Reason 1: Because vaccines, masking and distancing works
Reason 2: Because you’ve remained totally isolated
Reason 3: Because you did actually have it, you just didn’t know
Reason 4: Because household transmission is not a given
Reason 5: Because, well, luck

While there are clear, well-established mitigation strategies that have helped lower individual risk of contracting COVID-19, a lot of it comes down to a hefty dose of just good luck. There’s a lot of randomness to COVID. There are people who seem to have minimal exposure who come down with it, and there are people who have heavy exposure who seem to do OK.

The truth is that experts are still learning about COVID-19.

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Two Years of COVID-19 Pandemic

hands pressing on hand sanitizer pump

https://theconversation.com/covid-pandemic-2nd-anniversary-3-things-we-got-wrong-and-3-things-to-watch-out-for-177618
Exactly two years ago, on March 11 2020, the World Health Organization (WHO) declared COVID-19 a global pandemic.

This was two months after there were reports of a mystery virus infecting people in Wuhan, the most populous city in central China. Early reports said the virus didn’t appear to be readily spread by humans. Well, the SARS-CoV-2 virus could indeed be spread by humans. It quickly travelled around the world, and has so far infected more than 450 million people. COVID-19, the disease it causes, has to date caused more than six million deaths, making it one of the most deadly pandemics in history. In those early days we knew very little about the virus and COVID.

Here are three things we realised were wrong as the pandemic wore on, and three things we need to keep a close eye on as we approach the endemic phase, where the virus continues to circulate in the population at relatively stable levels

 

1. Many were worried we wouldn’t get a vaccine
In early 2020 we didn’t know whether a vaccine against SARS-CoV-2 was possible. There had been previous attempts to develop vaccines against severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), two similar coronaviruses that also caused outbreaks this century. A few of these vaccines entered clinical trials, but none were approved.

Before COVID, the fastest developed vaccine was for mumps which took four years. But in under 12 months, Pfizer/BioNTech developed a successful vaccine. Now we have 12 vaccines approved for full use in different parts of the world, 19 for emergency use, and more than 100 still in the clinical trial stages. Both Pfizer and Moderna have also commenced clinical trials of an Omicron-specific vaccine. There are also several research groups around the world developing vaccines aiming to work against all SARS-CoV-2 variants.

2. Some thought we didn’t need face masks
In the early days, without a vaccine, to reduce transmission we had to rely on individual preventative measures such as hand hygiene, social distancing and face masks. Although there was widespread acceptance hand washing and social distancing protected against infection, face masks were much more controversial. Before April 2020, the US Centers for Disease Control and Prevention (CDC) advised against the wearing of face masks by the public. There were apparently two reasons for this. First, the CDC was afraid there wasn’t a sufficient supply of surgical and N95 masks, which were essential in high-risk settings. Second, it was thought at the time asymptomatic and pre-symptomatic people could not transmit the virus (we now know they can).Health authorities initially held off recommending face masks, but this quickly changed. However, on April 3 2020, the CDC changed its advice and recommended the general public wear multi-layered cloth face masks.

This has now been updated to wearing a well-fitting mask that is consistently worn. With the advent of Omicron, some experts say cloth face masks aren’t up to the task and people should at least wear surgical masks, or even better respirator masks like a P2, KN95 or N95.

Doctors in Hazmat suits treating patient

3. We worried a lot about surface transmission
In the early days of the pandemic, it was thought contaminated surfaces were a major means of COVID transmission.

People wore gloves when going to the supermarket (some still do), and washed food packages once they got home. However, we now know the virus is spread primarily through aerosol and droplet transmission. When a person coughs or sneezes, droplets containing mucous, saliva, water and virus particles can land on other people or drop onto surfaces. Larger droplets tend not to travel very far and fall quickly. Smaller droplets called aerosols, can stay airborne for an extended period of time before settling. Scientists now believe transmission through touching contaminated surfaces is quite rare.

 

3 things to watch out for
There are three key issues we need to be aware of as COVID slowly becomes endemic.
1. Waning immunity
Many older and vulnerable people had their third dose in November or December last year, with their immunity now waning fast. We need to provide a fourth vaccine dose as soon as possible to the elderly and vulnerable.

2. New variants
There’s still the potential for new and more severe variants to hit us. One of the main reasons for this is the low rates of vaccination in many developing countries. The more the virus replicates in unvaccinated populations, the greater the chance of mutations and variants.

Vaccine manufacturers Pfizer and Moderna either manufacture the vaccine in their own facilities, or license the right to produce the vaccine in other countries. This puts it out of reach financially for most developing countries, who then have to rely on the COVAX initiative for supplies. COVAX is a worldwide facility funded by developed countries and donor organizations to purchase vaccines to be distributed to developing countries. Researchers at the Texas Children’s Hospital’s Center for Vaccine Development have unveiled a protein-based vaccine called Corbevax. It uses established and easy-to-manufacture technology, and is being provided patent-free to developing countries. It has now received emergency use authorization in India. It has over 80% efficacy against symptomatic disease, though this is against the no-longer dominant Delta variant. Trials are currently under way to determine its efficacy against Omicron. If approved, this should greatly help lift vaccination rates in many developing countries.

3. Long COVID
Politicians are ignoring long COVID. With thousands of cases a day, over the next year we will be getting a tsunami of people suffering from long-term health problems. So, we simply cannot ignore high case numbers and would be wise to retain at least some public health measures (for example, face mask mandates) in order to bring case numbers down.

The beginning of the end,

Governments are now dismantling public health measures such as the use of QR codes, social distancing measures and face mask mandates. Their thinking is that although case numbers are still quite high, hospitalizations are going down – and of course, elections are in sight. Chief public health officers, who used to give daily briefings, are now rarely seen. “Give us our freedom back” is now a commonly heard cry, even if the inevitable consequence means this is at the expense of elderly and vulnerable people.
In a nutshell, many believe we have moved already from epidemic to endemic status. As much as we all wish for this to be over and life to get back to normal, we aren’t quite there yet. But I think with better vaccines and improved treatments on the way, it’s at least the beginning of the end.

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Pfizer-BioNTech COVID

Pfizer-BioNTech Vaccine Bottle

Pfizer-BioNTech COVID vaccine less effective against infection for kids 5 to 11, study suggests

The vaccine’s efficacy against infection among those children declined to 12 per cent at the end of January from 68 per cent in mid-December compared to kids who did not get vaccinated, according the study, which has not yet been peer reviewed.
Two doses of the Pfizer-BioNTech COVID-19 vaccine was protective against severe disease in children aged five to 11 during the recent Omicron variant surge, but quickly lost most of its ability to prevent infection in the age group, according to a study by New York State researchers.

child wearing a mask doing crafts

“These results highlight the potential need to study alternative vaccine dosing for children and the continued importance layered protections, including mask wearing, to prevent infection and transmission,” the researchers said.

“It’s not surprising that protection against mild illness would wane, We know that Omicron is somewhat immune evasive for protection against mild illness. The goal of the vaccine is to protect against severe illness — to keep children out of the hospital.”

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Deer to Human Infection?

Researcher studying COVID-19

Possible case of deer-to human Covid infection identified in Canada
Researchers say its unlikely that the variant found in deer could bypass vaccines, but urge better monitoring of Covid in animals

Canadian researchers believe they have found the first-ever instance of a deer passing the coronavirus to a human, warning that broader surveillance of wildlife is needed to prevent further mutations from developing and spreading undetected.

deer standing in a field

In a paper published last week, but not yet peer reviewed, scientists say at least one case of Covid-19 in humans can be traced to a strain of the virus found in hunted deer.
Biologists have previously found white tail deer populations infected with Covid in northeastern regions of the United States, as well as central provinces of Canada. While deer aren’t typically seen as a species that can easily pass on the virus to humans, experts had nonetheless speculated that transmission was possible.

Researchers say its unlikely that the variant found in deer could bypass vaccines, but urge better monitoring of Covid in animals.

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National Advisory Committee

COVID-19 screening checkout at office building

The National Advisory Committee on Immunization (NACI) has concluded that a precautionary approach of separating the time between administering COVID-19 and non-COVID-19 vaccines is now no longer necessary and recommends that COVID-19 vaccines may be given concomitantly with (i.e. same day), or any time before or after, non-COVID-19 vaccines (including live, non-live, adjuvanted, or unadjuvanted).

Doctor filling need with COVID-19 vaccine

If more than one type of vaccine is administered at a single visit, they should be administered at different injection sites using separate injection equipment.

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Novavax Is Approved In Canada

Covid Molecules

Novavax has received approval for Canada’s first protein subunit COVID-19 vaccine called Nuvaxovid. Nuvaxovid (COVID-19 vaccine, recombinant protein, adjuvanted) is indicated for active immunization to prevent COVID-19 caused by SARS-CoV-2 in individuals 18 years of age or older. It will be an option for people unable or unwilling to receive an mRNA COVID-19 vaccine.

 

Action: Nuvaxovid is composed of SARS-CoV-2 recombinant spike (S) protein nanoparticles. A saponin-based Matrix-M adjuvant is added to enhance the magnitude of the S protein-specific immune response. Note that Nuvaxovid will be the first vaccine in Canada to contain the Matrix-M adjuvant and is NOT a mRNA COVID-19 vaccine.

Covid-19 text on a phone

Dosage: The manufacturer’s recommended dosage is two 0.5 mL doses, administered intramuscularly three weeks apart. However, the National Advisory Committee on Immunization (NACI) recommends an interval of eight weeks between the first and second doses, as this schedule is expected to provide a more robust and durable immune response and higher vaccine effectiveness.

 

Health Canada has not approved Nuvaxovid for use as a booster. However, NACI states that Nuvaxovid may be offered (off-label) as a booster dose to people who are not able to receive an mRNA vaccine, regardless of which COVID-19 vaccines were received in the primary series.

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Prescription Extensions At No Additional Charge

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Customers of Centrum Pharmacy can get PRESCRIPTION EXTENTIONS at no additional charge. We don’t charge for chronic prescription extensions like other pharmacies do.
Transfer your prescriptions to Centrum Pharmacy today. Simply call 613 837-4995 and we will take care of everything.
All major Drug Plans Accepted.
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Need to see a doctor? Can’t see your MD or are you without a Family Doctor?

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Don’t worry. Centrum Pharmacy has partnered with Virtual MD Canada for our patients to be seen quickly, usually within the same day or same hour. Just visit or call Virtual MD at

https://www.virtualmdcanada.com/
1-800-594-0537

And a licenced Ontario doctor will call you to discuss your needs. Just mention that you are a client of Centrum Pharmacy, and you will get a return call within the hour or schedule a time at your convenience.

OHIP covered Tele-Medicine visits available. Talk to a doctor from the convenience and safety of your own home.
Health Services Include COVID-19 Assessment/Counselling/Prescription refills/UTI treatment/Cold and Flu Assessments/Sexual Health Consultations/Aches, sprains, rashes, and more…

Contact our VIRTUAL WALK-IN CLINIC PARTNER

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Booster Doses for Youth

Pfizer Vaccine bottle with syringe

Booster doses for youth aged 12 to 17

 

Effective immediately, youth aged 12 to 17 can receive their third (booster) dose of the COVID-19 vaccine at Ottawa Public Health vaccination clinics. Drop-ins are welcome at all the clinics. Please visit the Ottawa Public Health webpage for clinic locations and hours. Please consult our website regularly as clinic hours are subject to change.

 

If preferred, booster appointments can be booked, starting Friday, February 18, online through the provincial booking system or by calling the Provincial Vaccine Contact Centre at 1-833-943-3900. Boosters for this age group are also available at some pharmacies administering the Pfizer-BioNTech vaccine.

Male youth getting vaccinated

Individuals must be 12 years old on the day they receive the vaccine and six months (168 days) must have passed since their second dose. A longer interval like this between doses results in a stronger immune response and is expected to also be longer lasting. This age group will receive the Pfizer-BioNTech vaccine.

 

Booster doses for people aged 12 and older previously infected with COVID-19

 

Vaccination continues to be the strongest protection against COVID-19, even for those with a prior COVID-19 infection. While infection alone may provide some protection, vaccination following infection is expected to strengthen the immune response and to provide a more robust and longer-lasting protection against COVID-19.

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Ontario Easing Public Health Measures

Stay Safe

Ontario will further ease public health measures, including, but not limited to:

Increasing social gathering limits to 50 people indoors and 100 people outdoors.
Increasing organized public event limits to 50 people indoors, with no limit outdoors.
Removing capacity limits in the following indoor public settings where proof of vaccination is required, including but not limited to:

Restaurants, bars and other food or drink establishments without dance facilities
Non-spectator areas of sports and recreational fitness facilities, including gyms
Cinemas.

Wash Your Hands, love each other

Meeting and event spaces, including conference centres or convention centres
Casinos, bingo halls and other gaming establishments.

Indoor areas of settings that choose to opt-in to proof of vaccination requirements.
Allowing 50 per cent of the usual seating capacity at sports arenas.
Allowing 50 percent of the usual seating capacity for concert venues and theatres.
Increasing indoor capacity limits to 25 per cent in the remaining higher-risk settings where proof of vaccination is required, including nightclubs, restaurants where there is dancing, as well as bathhouses and sex clubs.

Increasing capacity limits for indoor weddings, funerals or religious services, rites, or ceremonies to the number of people who can maintain two metres physical distance. Capacity limits are removed if the location opts-in to use proof of vaccination or if the service, rite, or ceremony is occurring outdoors.

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Federal Government Easing Testing and Quarantine

Parliament Hill from a rear view

The federal government is easing some of its testing and quarantine requirements for fully vaccinated travelers.

As of Feb. 28, negative results from rapid antigen tests taken no more than 24 hours prior to departure will be accepted from fully vaccinated travelers arriving in Canada. That will replace the current requirement for a negative result from a molecular test taken within 72 hours of departing for Canada. Those test results will also still be accepted from travelers.

Covid Antigen Test

Image rights belong to: Schengen Visa Info News

Antigen tests are typically cheaper and faster than molecular tests, and more widely available. The antigen test must be administered by a laboratory, health-care entity or telehealth service. Rapid tests administered at home will not be sufficient.

Mandatory random COVID-19 testing will continue at points of entry, but the government will drop the requirement that fully vaccinated travelers who have been outside Canada or the U.S. must quarantine while awaiting their test results.

Children under the age of 12 who are not yet fully vaccinated but have travelled with fully vaccinated adults will no longer have to avoid settings such as schools and daycares for two weeks.

The Federal Government will also lift its advisory against non-essential travel outside Canada

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