A NEW VISION OF AGING FOR CANADA

Second wave of COVID-19 certain

Experts say Atlantic Canada can pull through with right moves

The Chronicle Herald (Metro), 2 Jul 2020, ANDREA GUNN agunn@herald.ca @notandrea

With case numbers low or non-existent, the economy slowly reopening across the region, social distancing restrictions being relaxed and plans to allow travel within and to the Atlantic provinces, life is starting to feel a little more normal for many residents of the East Coast.

This might leave people wondering, is the coronavirus a thing of the past or is this just a temporary lull, with the rumoured second wave looming menacingly in the distance?

According to experts, the COVID-19 pandemic is far from over, but some things can be done to ease the second wave and better weather the storm.

Mary Jane Hampton, a health-care consultant and Nova Scotia’s former commissioner of health reform, said there will inevitably be a resurgence of the coronavirus in Atlantic Canada.

“This isn’t over … and to think this is over is a very dangerous and foolhardy position to take,” Hampton told Saltwire Network.

“It feels to me like we’re in the eye of the storm. It’s that kind of unnerving quiet that you really wish it was done, but you know pretty intuitively that there’s going to be something else that’s coming up behind.”

Susan Kirkwood, a professor and head of the department of community health and epidemiology at Dalhousie University and a member of the national COVID-19

immunity task force, said while it can’t be predicted exactly what’s going to happen, some clues can be gleaned from past pandemics, and how the coronavirus is behaving in other parts of the world.

“What we know is, certainly, in other pandemics like H1N1 or the 1918 influenza, what we see is a second wave and we see a very serious second wave,” she said.

The rate of infection is very low in Atlantic Canada, meaning that without a vaccine, whatever immunity that could exist in the population likely doesn’t, and this sets the stage for a strong second wave likely starting in late fall or early winter, Kirkland said.

She said a resurgence of COVID-19 can take two forms — the first is a resurgence of the coronavirus caused by travel and relaxed restrictions.

“There are definite challenges related to travel. If all of a sudden, we start moving around again, we’re going to see more cases,” Kirkland said.

Then there’s a true second wave — the likelihood that the coronavirus never truly goes away and continues to live in the environment, popping up again when conditions are favourable in the colder months, when more people are socializing indoors and people’s immune systems are already compromised by the resurgence of other seasonal viruses.

“Flus, for example, tend to wane off in the early spring, but then every single year the flu comes back. Well, where does it come from? It’s probably there all the time, but the situation for its spread is not as conducive,” Kirkland said. “The reality of it is there’s a large seasonality and it has to do with factors in the environment as well as factors within us.”

WEAK LINKS

While Hampton and Kirkland agree Atlantic Canada is better positioned than some parts of the world to weather a second wave of the COVID-19 pandemic due to factors such as a low population density, some things make the region more vulnerable, such as an aging population and the rural landscape spreading health resources more thinly than in other parts of Canada.

Kirkland said it’s important to ensure the coronavirus doesn’t spread to rural communities, as their health-care systems are not equipped in the same way they are in larger centres. Avoiding outbreaks in long-term care homes, where the majority of serious cases and deaths in Atlantic Canada occurred, will also be key to protecting the most vulnerable and reducing the spread of the coronavirus.

“I would hope that we’ve learned enough not to repeat it, but there is no short-term solution in long-term care. It is a long-term problem,” she said. “We’re going to have to act very quickly.”

Another weak link could be in keeping up contact tracing due to understaffed public health sectors, Hampton said. In Nova Scotia, for example, there are only about two dozen people committed to full-time public-health work, she said.

“Not only have they had the weight of public expectations, but they also have the burden of quite literally needing to protect a million lives, and they’re exhausted,” she said.

The kind of work done in public health, such as contact tracing, which Hampton said is crucial to managing the spread of the coronavirus, is a hugely labour-intensive and highly developed skillset that’s not easily transferable to new hires.

“If they stumble in their ability to support the vigilance in the contact tracing and updating of evidence-based protocols for the public to use, we’re sunk,” she said. “So, at some point, we need to figure out how to bolster our public health assets so they can ride the wave.”

Hampton also said she is worried about impatience, both within people’s normal lives leading them to become complacent with the rules and restrictions, but even more crucially within the healthcare system, where there is a backlog of planned and elective procedures that were put on hold during the first wave of the coronavirus.

“There will be an intention to ramp the mainstay health system back up, possibly too quickly, and if we start to take up all the operating room and intensive care beds with other needs, we could get swamped by the second wave,” she said. “We need to manage that tension and continue to manage the public’s expectation in that regard and not let our guard down.”

STAYING VIGILANT

Kirkland said it’s crucial as some restrictions start to relax that Canadians stay absolutely vigilant in areas such as hand washing, social distancing with people outside of their bubble and wearing masks in public.

She also said continuing to do widespread testing to detect new outbreaks, and keeping travel to and from places with high rates of infection to a minimum (and ensuring people self-quarantine when they do travel), is also important.

In general, Kirkland said, the fact that Atlantic Canada has had time to prepare and doing so will serve the region well in the event of a second wave.

“We just have to prepare as if it is going to happen. The worst-case scenario, if it doesn’t happen, is we’ve overprepared,” she said.

Hampton said she is concerned that, as people begin to see the numbers climb in a few months, Canadians will become resigned to the fact that the coronavirus cannot be stopped and give up, which could have dire consequences.

“Look at what can only be described as the apocalypse happening south of the border. … That’s not a future we need to embrace, but if things start to get ugly, I think the same resignation we’re seeing [in the U.S.] could be reflected in Canada,” Hampton said.

“We did such a good job of protecting ourselves from the first wave, to be in the eye of the storm and then get wiped out as it comes through the second time around would be the ultimate tragedy.”

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