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Ontario doctors try to predict everyday life in the third year of the COVID-19 pandemic

Things keep changing, but Ontario is definitely moving to a ‘new normal’ way of living
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With COVID-19 case counts on the rise and with the Omicron Variant spreading faster than any other version of the disease, Ontario residents can expect more of the same in the way of public health restrictions, the call for more vaccinations and evolving medical knowledge about the virus.

Those were some of the findings that came out of an online media briefing held Tuesday by the Ontario Medical Association (OMA) to discuss the future of the pandemic.   

OMA president Dr. Adam Kassam hosted the Zoom webinar to mark two years since the first case of SARS-CoV-2 (COVID-19) virus was discovered in Wuhan, China back in December of 2019. It prompted the OMA to ask member doctors what Ontario residents can expect as we move into year three.  

Kassam said in the past two years our lives changed in ways we never imagined as science and society tried to get a handle on the disease.

"Working from home; wearing masks; hand washing; social distancing; fist bumps instead of hand shaking; vaccine certificates to get into public places; curbs on travel; online workouts; online shopping; debit instead of cash; smaller gatherings including at weddings and funerals," said Kassam. 

He added that some degree of normalcy has returned in the sense that there is no formal lockdown. Vaccination rates are high and getting higher. Children are getting vaccinated and most have returned to school. Family members and friends are able to spend more time together in small settings. Some people are even able to travel, although the recommendation is to stay in Canada, said Kassam.

Even with all that, Kassam said there is still a significant concern.

"We are dealing with yet another new variant, Omicron. Scientists are still assessing how it will behave. And already public health officials here in Ontario are warning it will become a dominant strain very soon," Kassam said.

He added that "pandemic fatigue" is peaking. He said Ontario residents are feeling stressed about having to go through more restrictions, again. Kassam said it is not easy and Ontario residents have many questions about what is ahead.

"So what can we expect as we enter our third year? Will the ways of infection continue. What do we know about Omicron? And how can we best protect ourselves? What will the new normal look like? And what are the things that we will never do again and things that we will always do differently as we learn to adapt to a virus that isn't going away for good?" he asked.

One of the speakers at the webinar was Dr. Allison McGeer, a professor in laboratory medicine and pathobiology at the Dalla Lana School of Public Health at the University of Toronto. She said the Omicron Variant is a serious concern.

"This is really bad news for us at this time, '' said McGeer. 

"Omicron moves faster than other variants. And the pace of it we're leaving in Ontario is accelerating very quickly, we're on track to have 5,000 or 6,000 cases at the end of the month, which is much faster than other variants taken over. And so what that means for the beginning of 2022 is some very difficult decisions and some difficult times," said McGeer. 

She added there was good news out of South Africa Tuesday morning in that Omicron "appears to be a little less severe".  

McGeer said that was good, but not good enough. She said she was encouraged that Ontario is now providing third-dose vaccine booster shots for individuals aged 50 and older because that will help fight the spread of the virus. But McGeer said that doesn't mean we're in the clear. 

"So there's no question that we are facing a really discouraging and depressing and difficult time for the next month,"  said McGeer.   

"We're going to need additional public health restrictions. And that's obviously going to need to be accompanied by support for the people who are going to suffer from those restrictions. If we choose not to do that, then we're looking at a health-care system that is going to be overwhelmed sometime in early to mid-January," she added.

Also speaking at the webinar was Dr. Ripudaman Minhas, a developmental pediatrician with the Women’s and Children’s Health Program at St. Michael’s Hospital and an assistant professor in the Department of Pediatrics at the University of Toronto. He said his concern is that there is more work needed to support children in the pandemic and for whenever Ontario is able to move out of the pandemic.

Dr. Minhas was able to cite some specific cases involving older and younger children and the challenges they are facing in terms of schooling and learning losses. 

"And, you know, the impact of school disruptions on Ontario students has not yet been fully evaluated. And that's something that's in the works right now. In the US and in the UK, researchers have recorded significant impacts of school closures on academic performance. And we know that longer closures result in larger learning losses as well, even with virtual learning in place," said Minhas. 

He added he is hoping everything will be done to keep schools open and operating safely for children. Minhas said another significant concern for younger people is finding ways to resolve mental health issues.  

"And during the pandemic, I've really been urging families to see their health-care team or their mental health professional if they see changes in their child's behavior, including ongoing low mood, changes in appetite or sleep, or unusual or self harming behaviors. And in clinic, I've been trying to suggest that all families really try to make space for their children's feelings at home, and also their own," he said.

Dr. Onil Bhattacharyya also spoke at the briefing. He is the Frigon Blau chair in family medicine research and director of the Institute for Health Systems Solutions and Virtual Care at Women’s College Hospital in Toronto.  

He said the Spanish Flu was also a two-year pandemic that gradually petered out in intensity, but transitioned to a less deadly version of influenza such as the ones we see today. He predicted that the coronavirus will be around for a while.

"I think it means adjusting to a world where case counts of coronavirus rise and fall based on public health measures, vaccination rates, the rise of new variants. The previous waves were managed with a range of ad hoc measures. Some thought were too late and some too little too late. Others felt were too stringent. Government would propose things and backtrack when there was too much pushback," said Bhattacharyya.

He said society needs to communicate about what is "acceptable" in terms of living with the virus in the future.  He said this would include the number of hospitalizations, ICU bed uses and acceptable thresholds for taking action.

"There's no right answer, but there are acceptable compromises within a society. Our threshold could be lower than the US and UK which have tolerated a higher number of cases and deaths. But it might be higher than Australia or Singapore. What measures we take will depend on how we value the well-being of children, of essential workers, and of our economy. It'll depend on the level of surveillance and social control that we're willing to accept in the interest of public health. All of this can be debated and reasonable compromises can be found," he said. 

Len Gillis is a Local Journalism Initiative reporter at Sudbury.com. He covers health care in Northern Ontario.


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Len Gillis, local journalism initiative reporter

About the Author: Len Gillis, local journalism initiative reporter

Len Gillis is a Local Journalism Initiative reporter at Sudbury.com covering health care in northeastern Ontario and the COVID-19 pandemic.
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