Some Room for Optimism - Again

Cautious optimism is the phrase most often used by health experts to describe the current phase of our pandemic struggle. There are many reasons to think we're well past the worst of it but still lots of cause to remain careful.


An unforeseen summer surge in COVID numbers has been followed by an unexpected drop in early fall. High vaccination rates and restrictions that limit exposure to the unvaccinated have certainly helped.


We have also had continued summer-like weather, delaying the move indoors, where the virus is 20 times more likely to spread. We'll need to keep a close watch on the trend line as we head into November and December.


The better-than-expected numbers have caused the Province to loosen some restrictions, such as allowing 100% capacity at indoor sports and entertainment venues where all patrons are required to be fully vaccinated (and masked under most circumstances).


It is expected that this approach might soon be extended to restaurants, bars and gyms where vaccine mandates are also in place but capacity is currently limited to 50%.


Although I am personally unlikely to risk dining in a crowded indoor space where masks are removed so people can eat, it's an inevitable step if these businesses are to survive and a reasonable choice for those who view this as an acceptable risk.


I am much less sanguine with the Provincial musings about eliminating vaccine mandates, perhaps by early next year. In general, the vaccinated have a much lower chance of getting COVID or spreading it, so having them together is an entirely different level of risk than occurs when you introduce unvaccinated people into the same crowded indoor situation.


Other COVID new this week:


While the United States is making it simpler for Canadians to cross the border, getting back home might not be so easy.


Starting November 8, fully-vaccinated Canadians will be able to cross by land - a COVID test is not required. Canada, however, will require a negative COVID test within 72 hours of returning. Those travelling less than three days can be tested in Canada and use that test to re-enter. But those on longer trips will need to purchase a test in the U.S., at an estimated cost of about $200 per person.


Another glitch about whether the U.S. will accept mixed doses appears to be getting resolved. With a more plentiful initial supply, the U.S. administered double doses of the same vaccine according to the manufacturer's timetable of less than four weeks. Canada, however, spread doses months apart to get first doses into more arms, faster. Due to supply interruptions and concerns about AstraZeneca, Ontario encouraged mixing vaccines.


Subsequent research has shown this approach to have been beneficial in two unexpected ways: a longer time between doses increases protection; mixing vaccines creates higher antibody levels.


Given the latter finding, the U.S. may encourage a mixing of doses for booster shots – especially for those whose only dose is the one-shot Johnson & Johnson vaccine, which has a similar rare side-effect to AstraZeneca.


Finally, before you pack your bags, be aware that U.S. COVID cases are much higher than here – especially in regions with low vaccination rates – and Canadian officials have cautioned against unnecessary travel.


Quite apart from their greatly increased COVID risk, and the restrictions on entering restaurants or sports venues, it is becoming increasingly difficult for the unvaccinated to carry on with their pre-pandemic lives.


Many employers, especially public sector ones such as the City of Toronto, are approaching deadlines for employees to either be vaccinated or have their employment suspended.

In an area that could be the tip of a wider debate, the University Health Network (which operates Toronto General, Toronto Western and Princess Margaret hospitals) has announced it will stop providing organ transplants to those who are unvaccinated. With life-saving organs in short supply, UHN wants them to go to patients with the highest chance of survival, particularly where elevated risk is a matter of choice. Transplant patients are among those with the highest risk of death from COVID.


Earlier today, Italy became the first Western democracy requiring the entire workforce, in both the public and private sectors, to be fully vaccinated. Under the new rules, those without proof of vaccination will be required to take an unpaid leave.


In France, starting today, unvaccinated people will, in effect, have to pay extra to go out. That's because the unvaccinated will be required to pay for their own testing. In that country, a negative test is an alternative to being fully vaccinated for those entering public places such as restaurants and theatres. Tests will remain free for vaccinated people.


In the United States, many unvaccinated people are required to pay a surcharge for medical insurance. Delta Airlines announced it would charge any employee who remains unvaccinated an extra $200 per month to remain on the company's health plan. In Louisiana, the state's largest health care provider said it will charge an extra $200 per month for unvaccinated spouses covered by the company's insurance plan.


Hopefully, this will all be behind us by the time that one of Willowdale's newest residents is old enough to hear about it. This week's song goes out to Sweet Baby Louisa Emmaline James, 7 lb. 6 oz. of goodness, who arrived to make life even more joyous for Joanna and Jesse James (who many of you know for his work in my office and the community)


-John