On July 22, Alberta Premier Jason Kenney tweeted that the province was “moving from a pandemic to an endemic state of COVID-19.”
The analysis, which led to a lifting of virtually all public-health restrictions, was dreadfully wrong. It was based on two wrong assumptions: That case numbers would remain low and, even if they did rise, severe illness and hospitalizations would not.
On July 22, Alberta recorded 106 cases; this past Friday, the daily case count had soared to 1,473. The number of hospitalizations and intensive-care admissions are ugly, too – 686 and 189, respectively – to the point where elective surgeries have been cancelled because some hospitals are overwhelmed.
Saskatchewan is, in many ways, worse than Alberta because Premier Scott Moe doesn’t even pretend to have a strategy other than denying the reality that the pandemic is still a threat.
Everyone desperately wants the pandemic to be over. It would be great to move from a pandemic state (where the coronavirus is circulating widely and sometimes out of control), to an endemic state (where the virus is circulating at a low level and under control).
But when you hear the term “endemic” invoked, as you will increasingly in the coming weeks, remember that status has to be earned. It can’t be achieved with wishful thinking or blissful ignorance.
Both Alberta and Saskatchewan acted prematurely in lifting restrictions, when vaccination rates were still too low, and that made resurgence easy and predictable.
There is a growing scientific consensus that COVID-19 is here to stay, that the virus can’t be eliminated or eradicated.
Practically, that means SARS-CoV-2 (the official name of the coronavirus) will likely become a seasonal visitor, much like influenza.
But endemic is not a synonym for benign. The flu still kills thousands of Canadians a year, and COVID-19 will likely do so for many years to come.
During the pandemic, because of measures such as mask-wearing and physical distancing, the flu virtually disappeared. But when we return to “normal” (or whatever the new normal becomes), the confluence of COVID-19 and influenza each fall and winter could become a major public-health challenge.
The question becomes, crassly: How much illness and death are we willing to accept as “normal”?
When we accept that an illness will be designated as endemic, that’s one of the tough questions we have to answer. With infections such as influenza, whose dangers have waxed and waned over a century since the Great Influenza epidemic of 1918-19, we never had that discussion. With COVID-19, we can have it quite explicitly.
If we can’t get rid of the coronavirus, we can at least minimize its impact.
Vaccination is obviously the most effective tool for doing so. Getting COVID-19 vaccines approved for children will go a long way toward that goal.
But while vaccination is important, it’s not the be-all and end-all.
In a world where COVID-19 is endemic, masks will still have a place. Why would we allow visitors to high-risk settings such as hospitals and long-term care homes to go unmasked when this small gesture clearly helps limit disease transmission?
In the future, when we have sporadic outbreaks of COVID-19 – say in schools or workplaces – temporary mask mandates should become a reflex.
Our culture of going to work sick also needs to change, and that requires better sick-leave policies.
So, too, does our casual acceptance of schoolchildren as vectors of disease. To limit the dangers of infectious diseases – COVID-19 and beyond – class sizes should be much smaller, and proper ventilation should be a priority.
After more than 18 months of COVID-19 gripping our lives in Canada – four waves and counting, and a frustrating series of on-and-off lockdowns and restrictions – one of the most frequently asked questions is “When will this godforsaken pandemic end?”
The short, depressing answer is: Not any time soon.
Still, we have the tools to significantly minimize the pain and hardship, at least domestically.
Denmark provides a shining example. The Nordic country just lifted all COVID-19 restrictions and declared the virus was no longer “socially critical” and could be considered an “ordinary dangerous illness.”
The newfound freedom didn’t come easily: 548 days straight of pandemic restrictions (unlike Canada’s on-again, off-again approach), more than 80 per cent of eligible citizens vaccinated and a commitment to lock down again if there is a flare-up.
This is the endemic state we want to strive for in the short term – but it requires hard work, not self-destructive impatience or magical thinking.
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André Picard