High vaccinations, low cases: When is it safe to lift COVID-19 restrictions?

With Ontario’s COVID-19 case numbers plateauing in recent weeks, Premier Doug Ford announced Friday afternoon the province’s new plan for gradually lifting remaining restrictions.

Beginning Monday, the province is lifting capacity limits on restaurants, gyms, indoor event spaces and other venues where proof-of-vaccination is currently required, and anticipates lifting proof-of-vaccination controls in some venues starting in the new year.

B.C. also announced earlier this week that it will be lifting capacity limits on indoor gatherings, while Quebec will lift capacity limits on bars and restaurants starting Nov. 1.

But, we’ve been here before. When Ontario lifted restrictions in early 2021, case numbers shot up. The same happened in Alberta over the summer. 

That doesn’t mean we shouldn’t try easing restrictions, said Dr. Anna Banerji, a pediatric infectious disease specialist and associate professor in the University of Toronto’s department of medicine and school of public health.

“I think that now is a good time to cautiously open things up,” she said. Although opening up too quickly risks a resurgence in cases, opening things carefully and using tools like proof-of-vaccination requirements could be safe,” she said.

“When they’re opening up stadiums to 20,000-30,000 people with no spacing between, it really doesn’t justify keeping things like restaurants closed,” she said.

Mike Willis, a heart transplant recipient from Guelph, Ont., agrees.

“I think it’s a good thing,” he said. “At the same time, even though I’m triple-vaccinated, my antibody levels are way lower than a lot of people who have had only one shot. With the anti-rejection meds I take, I have to be very careful and have been being careful for over six years or so.”

Limiting access to certain venues to only vaccinated people makes him feel better about reopening.

“If people are careful, we need it for the economy,” he said.

Others aren’t so sure reopening is a good idea right now.

Dr. Susy Hota, medical director of infection prevention and control for Toronto’s University Health Network, urges caution.

“Across Canada, we’re at 88 per cent or above that for first doses. So I think we’re heading towards a very nice-looking number for eligible populations,” she said.

Still, she noted, it’s hard to say exactly at what point herd immunity would kick in.

“What’s the magic number? Nobody really knows.”

When considering reopening, she thinks authorities would want to see a clear trend of declining case counts.

“If you’re just on the point of starting to step down on the curve, that’s too early. You would need to make sure that it continues in that trend because further reopening can spin you back up into exponential growth,” Hota said.

She also thinks that governments should make sure that hospital numbers have receded as well, and consider giving health-care workers “a breather” after a wave of cases, rather than potentially plunging them right into a new one.

Then there’s the unvaccinated, including some kids who aren’t yet eligible. Hota would prefer waiting a few weeks to see if vaccines for children aged 5-11 are approved before proceeding with reopening. Pfizer Canada has submitted its application for a COVID-19 vaccine for that age group, and Health Canada is currently examining it.

A statement from the Children’s Health Coalition, a group of children’s hospitals and medical providers, urges a “cautious approach” to reopening that “doubles down” on measures to protect school-aged children, including keeping community transmission of the virus down.

Dr. Don Vinh, an infectious diseases specialist and medical microbiologist at the McGill University Health Centre, isn’t sure that now is the time to start relaxing COVID-19 restrictions.

“It’s like a campfire,” he said. “There are some places where the flame is going and those people are in trouble. And there are some other places where the flame is dying or it’s only embers.”

The risk, he said, is that if you walk away from embers they can reignite. And if you reopen too quickly, you “invite the possibility of an increase in community transmission.”

“Why do a medical cha-cha? Why two steps forward and one step back?”

Banerji said that given Canada’s high vaccination rate, a slow reopening could work.

“I think having those vaccinations and having a vaccine passport allows people to engage in a way that we couldn’t last year,” she said.

Having school-aged children vaccinated will make a difference too, she said.

“I’m hoping that once they’re vaccinated, that most of society is opened up again, especially to people who are vaccinated. It would make sense.”

by Global News