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“Nasty fall ahead.”

Those three words, tweeted by the ever-insightful David Naylor, the co-chair of the federal COVID-19 immunity task force, pretty well summarize what awaits us as we try to look beyond the once-hopeful summer of 2021.

The much-dreaded fourth wave of COVID-19 has begun in much of Canada. Fuelled by the Delta variant, it could be the toughest one yet.

The fall and winter of 2021 likely won’t be anywhere near as devastating as the winter of 2020, at least in sheer numbers. We can thank Canadians’ broad embrace of vaccination for that.

Delta variant stands to tap brakes on Canadian economy, not slam them

But we’re going to experience a new kind of nasty, with a lot more children and young adults getting sick and hospitalized than in earlier waves.

With ageism rampant in our society, it felt as if Canadians were shrugging off the death of elders. Of the 26,669 COVID-19 deaths recorded in Canada so far, 18,194 have occurred in residential facilities, principally long-term care homes, according to data compiled by journalist Nora Loreto.

Seeing children on life support in intensive care units will be a whole other matter. We need look no further than pediatric hospitals in Louisiana and Texas to get a sense of what could be coming.

To date, young people have not been as hard-hit by COVID-19. But the Delta variant is different; people of all ages are getting sicker quicker, especially if they are unvaccinated. A significant minority of infected children and youth will develop lasting symptoms, a condition called “long COVID.”

The fourth wave is also unfurling in a markedly different socio-political environment.

The pandemic is now a pandemic of the unvaccinated. The unjabbed account for almost all cases, hospitalizations and deaths. The unvaccinated are principally split into two distinct groups: those for whom vaccines are not yet available, such as children under 12, and those who are choosing to not be vaccinated.

The small minority of vaccine denialists, vaccine opponents and anti-lockdown activists are becoming increasingly obnoxious, their embrace of disinformation and conspiracy theories more adamant.

The vaccinated are increasingly angry, too. They don’t appreciate their civism being undermined, and are demanding vaccine mandates, certificates and passports, and punitive measures against those still refusing.

Many governments, especially conservative ones, are abandoning public-health measures, betting that the public (or at least their base) is fed up with pandemic restrictions. The problem is not that governments have loosened rules, which was largely justified by low case counts and high vaccination rates; it’s that many never established metrics or set out terms for potentially reinstating them if things went south.

As numbers rise, we will undoubtedly see some backpedalling, with a return to masking and limits on social gatherings, but they will be increasingly difficult to enforce. Hopefully we won’t see perverse actions such as the punishments being handed out by Florida’s Governor on businesses insisting on masks or proof of vaccination.

In the U.S., the response to COVID-19 has become deeply partisan, with Democrats embracing masks and vaccines, and Republicans vehemently rejecting them. We can’t afford to have that happen in Canada, but the current sniping between Ottawa and the Alberta government does not bode well.

There is a danger, too, that a federal election – which is looking increasingly likely to come soon – could exacerbate this political cleavage.

Still, there is hope. Our actions (or inaction) will determine the size of the wave and, ultimately, how nasty the fall will be.

Since the early days of the COVID-19 pandemic – in case you’ve forgotten, the virus was being reported as early as late 2019 – Canada has enjoyed the advantage of looking to other jurisdictions that were hit earlier to get a sense of what was coming our way.

That advantage remains true today. What is happening in the U.S. and Europe today foreshadows what we can expect in the coming weeks and months: A sharp rise in cases, and a spike in hospitalizations and deaths, particularly in the unvaccinated. But none of this is inevitable here.

Despite all the noisy disinformation out there, we need to remember that vaccines work remarkably well. Canada has just surpassed 50 million doses administered, and 23.3 million Canadians are fully vaccinated. Masking and physical distancing also remain effective, and we shouldn’t abandon them too hastily.

Our particular focus this fall and winter needs to be on children and youth. Ensuring they can attend school as safely as possible means having some clear guidelines, and investing in measures such as ventilation and smaller class sizes.

But the single biggest factor in protecting children remains keeping community spread of the novel coronavirus in check.

If we do that, then come early 2022, we’ll be able to look back and say: “It wasn’t so nasty after all.”

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