Home Health COVID-19 Eased restrictions during high case counts seem counter-intuitive

Eased restrictions during high case counts seem counter-intuitive

Allowing up to 4 in-person faith-based gatherings | Opening up long-term care visits

Thursday March 25, 2021 | VICTORIA, BC

Editorial Analysis by Mary P Brooke, B.Sc., editor | Island Social Trends

Triple concern: combine back-to-school after spring break next week, with allowing in-person faith gathering, together with opening doors wide for social visits in long-term care — all of that during high case counts (800 today, 647 seven-day rolling average, and the positivity rate climbing all week).

This seems to all come a bit early — and very much all at once — ahead of the full impact of vaccinations (still at only 12.7% of adult population).

And this as well in the context of Provincial Health Officer Dr Bonnie Henry opening her media session today with a focus on the impact of COVID on young adults… a focus that has been long in coming despite that the COVID virus is a simplistic predator that obviously seeks to transmit regardless of the age or demographic of the human host.

COVID, age 19 to 39, BC
The number of cases in people ages 19 to 39 has been increasing since mid February 2021. [BC CDC]

She also admitted that case numbers are higher because her contact tracing teams have more time and resource now to track down cases (now that immunization is having a positive effect on pushing down case numbers). Does that mean many cases were being missed before?

Politics vs science:

Premier John Horgan, COVID
Premier John Horgan along with Dr Penny Ballem (background) as COVID immunization rollout executive lead, during media availability March 24, 2021 about introducing tourism workers into the immunization clinic infrastructure.

Is this a case of balancing an approach of ‘aim to please’ (political considerations due to public pressure) with science? Where is the science in today’s effectively opening the social contact floodgates at a time when case counts and COVID viral transmission (including variants) is extremely high?

A few times in recent weeks Premier John Horgan says he has heard from a very wide range of individuals, groups and sectors about why they should be moved up in the vaccination queue. That’s another aspect of the political pressure.

Horgan along with his health minister and provincial health officer have had the faith-based group leadership on board since last year (having had several meetings with them), but it seems that year-two of the pandemic has seen a limit of tolerance reached. Many aspects of society are on hold.

easter eggs

Putting celebrations like Easter, Passover and Ramadan into cyberspace one more time would not be the end of the world. But obviously there is pushback.

However the changes will allow for four (4) in-person gatherings of up to 50 people (or 10% of available meeting space — whichever is less) between March 28 and May 13, 2021 [link to the full PDF of that revised order].

The easing of social restrictions as announced today by Dr Bonnie Henry in a joint media session with Health Minister Adrian Dix has social media all a twitter. There is something contrived about these changes today that is striking people as a taste of ‘normal’ but coming too soon. Among the vocal groups are teachers, with the BC Teachers Federation calling for stricter mask regulations for classrooms after spring break.

COVID, BC, March 25 2021
COVID-19 dashboard for BC at March 25, 2021 showing daily case counts from Nov 2020 to present. [BC CDC]

Both Dr Henry and Minister Dix repeated how important it is to follow the public health protocols that work (physical distancing, wearing a mask indoors, washing hands, socializing only within your household) while opening the floodgates of scenarios that are sure to generate more cases (as Dr Henry admitted today in her comments to media).

BC COVID profile shows stubborn numbers:

Adrian Dix, Health Minister, March 25 2021
Health Minister Adrian Dix on March 25, 2021: “If you know a senior who needs your support, provide your support.”

Today’s new COVID case count at 800 is one of the highest in the pandemic to date (now in year two of this health emergency). With 5,856 active cases province-wide and 9,964 people self-isolating due to known exposure (not to mention five more deaths), where is the logic in opening up so much of the social interaction?

It’s not really about logic, it’s obviously about responding to public pushback during the now-termed ‘COVID fatigue’. It seems like a weak (caving to pressure) approach during a serious situation, and puts individuals, families and clusters of people (including families who want to visit in long-term care) into tough decision-making situations.

The government is bending to public demands but essentially washing their hands of the responsibility to get this right. It’s a blind stab in the dark: ‘Let’s give this a try and see if people adhere to their best-practices’. But that has been shown not to work, already.

Long-term care then or now?

Easing things up in long-term care would have had more success with the public (and residents of long-term care) if it had been phased in slowly with well-managed precautions. Did public health officials feel that long-term care homes weren’t up to the task of managing it well before now?

BC Seniors Advocate Isobel Mackenzie, COVID-19
BC Seniors Advocate Isobel Mackenzie addresses the impacts and needs required for seniors during COVID-19, in a media session on Sunday April 26, 2020.

BC Seniors Advocate Isobel Mackenzie did call for “more compassionate” attention to the needs of elders in long-term care (regarding visitors) almost a year ago (in a media session April 26, 2020).

Many times over the course of the pandemic Dr Henry has said the risk was too great. She is basing her easing-up of social containment on the success of vaccination of residents and workers in long-term care (Dix said today that in the 90+ age category a “substantial number have been immunized”).

But there is still risk, Dr Henry said today. Though there was always risk — and the risk to damaging families emotionally for a very long time was handled in a very black-and-white manner until now — essentially an all or nothing approach. The trauma that will remain with family members of people who died alone in long-term care cannot ever be fully measured and will have long-term impacts.

There most certainly is the science of data in public health, there is also the art of working with the souls of people in the spectrum of health. The long-term care experience in BC (and across Canada for that matter) has for the most part lacked that element of care.

Minister Dix did point out today that presently there are two long-term care facilities and one assisted living facility dealing with outbreaks, compared to 42 long-term care and 49 assisted living facilities in that boat at January 15, 2021.

“It will make an extraordinary difference,” to the residents and families who visit in long-term care, said Dix today about the changes that Dr Henry has made to the public health order about visits into congregate living facilities.

long-term care, visits, BC
Changes to long-term care social visits as of April 1, 2021 [BC CDC]

The changes to visits in long-term care that start April 1, 2021 are online.

Serious infection at any age:

Serious illness due to COVID infection is now being seen in younger people — even in their 30s — as the older population becomes vaccinated.

COVID-19, B.1.1.7, UK variant
The B.1.1.7 and B.1351 variants of the COVID-19 virus are more contagious, and the P.1 variant is picking up steam (in clusters).

“COVID is a vicious enemy,” says Health Minister Adrian Dix, as the virus will continue to find human hosts in which to reproduce.

The goal of public health is of course to achieve herd immunity (generally thought to be at least 60 to 70% immunization coverage) as explained many times over the past year by Provincial Health Officer Dr Bonnie Henry.

Vaccination profile at March 25:

There have been 610,671 doses of COVID-19 vaccines administered in BC to date, reported Minister Dix today. Of those, 87,212 are second doses (presumably offering fuller immunity).

immunization clinic, March 2021
Immunization clinics are busy in BC, like this one in Langford. [Island Social Trends – March 23, 2021]

It is not yet known how effective the current vaccines are against the variants of the SARS-CoV-2 (COVID-19) virus that are gaining ground in the BC COVID case stats.

Today people age 75+ could start booking their vaccination appointments. Tomorrow (March 26) the appointment bookings open to people age 74+.

Starting March 29 at noon, people with higher risk conditions (called CEVs or clinically extremely vulnerable) — who receive letters with an invitation to be vaccinated — can start booking their appointments.

high priority, vaccination
People at higher risk from COVID-19 due to existing medical conditions, such as various forms of cancer, transplant recipients and severe respiratory conditions, will be able to register for their COVID-19 vaccine beginning Monday, March 29, 2021. | BC Government link – Clinically Extremely Vulnerable

Variants of Concern:

Today there were 191 new cases caused by the three known variants, bringing the total to 1,772 (1,549 B.1.1.7/UK; 47 B.1.351/South Africa; and 176 P.1/Brazil). Presently 215 of those cases are active.

The B.1.1.7 is replacing the ‘original’ virus in the positive case profile, said Dr Henry twice this week. As the P.1 variant shows more prevalence Dr Henry says that variant is being found in identified clusters.

Vancouver Island profile at March 25:

There are currently 279 active COVID cases on Vancouver Island at March 25, with a total of 3,041 cases pandemic-to-date. Fifteen people are hospitalized due to COVID-19, with now just one in ICU; total hospitalizations in Island Health pandemic-to-date is 162.

Vancouver Island, COVID, March 25 2021
COVID-19 dashboard for Vancouver Island at March 25, 2021 showing daily case counts from Nov 2020 to present. [BC CDC]

There have been no new deaths in Island Health since March 8; the total stands at 28.

The positivity rate has been climbing all week, now at 3.9 in Island Health — up from 3.5 on Monday, and 3.4 before the March 20-21 weekend. Positivity indicates how many positive tests are found in all tests reported that day. The BC average is now at 8.5, while the Canadian average is 3.7%.

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===== LINKS:

On December 16, 2020, enforcement measures were expanded.
Details here: https://news.gov.bc.ca/releases/2020PREM0108-002083

On November 24, 2020 a mask enforcement order was introduced in BC under the EPA, requiring masks for people over the age of 12 in public indoor settings, unless they are exempt. Details here: https://news.gov.bc.ca/releases/2020EMBC0061-001960

For information on all recent orders and guidance, as well as general COVID-19 information for all British Columbians, visit: www.gov.bc.ca/covid19

Tourism industry personnel helping out at immunization clinics (March 24, 2021 | Island Social Trends)

MapleLine Business Centre, digital marketing
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Locations of Island Health immunization clinics: Island Social Trends article on the clinic rollout March 7, 2021 | direct link to Island Health clinic location list (will have regular updates)

BC CDC COVID-19 dashboard (updated Monday to Friday)

Island Health, regions, COVID, March 252021