New Brunswickers have an opportunity to change the course of how the triple threat of respiratory viruses overwhelming hospitals across the country unfolds in the province, says the acting chief medical officer of health.
Dr. Yves Léger says the early increase in the flu and large number of children falling ill to respiratory syncytial virus, or RSV, combined with COVID-19 is "worrisome."
"If we don't all work together, this may put our health-care system in a very difficult position, being strained to the point of having to make difficult choices about the service they can and can't provide," he told reporters during a briefing Friday afternoon.
Even though only a small percentage of those infected will end up requiring hospitalization, when a lot of people get infected at the same time, it means more people will require hospital care at the same time, he said.
"This adds to an already strained health-care system — and that's a big problem for everyone."
Schools and workplaces either are or will feel the impact as well through increased absenteeism, he said.
'Back to the basics'
Léger was unable to provide any statistics, but said the health-care system is already "seeing its share of challenges."
And while he can't predict exactly how the rest of the season will go, he expects it "may get worse."
"We have an opportunity to change the course of how this unfolds in New Brunswick and work collectively to keep each other healthy and protect the health-care system," Léger said.
"If we want to play our part, then we need to go back to the basics of wearing our mask when we're indoors, staying home if we're ill, staying up-to-date on our vaccines, making sure we wash hands."
He also encourages people to limit their social contacts in the coming months, including the holidays.
"I know it's not always pleasant or convenient, but … this is not just about us, but our friends, our families, our communities. We need to look after each other."
Not recommending a mask mandate
Léger is not recommending a return to mandatory masking at this point for several reasons, including the fact there is some immunity now through vaccines and infections, and transmission doesn't always happen in public settings, so the "benefit would be limited."
In addition, mandates are not easy to implement, and have been difficult to enforce, he said, citing retailers in particular.
"Of course, if the public's not on board, then that's going to be an issue as well. If large groups of the public aren't going to follow the mandate, that won't be very effective," said Léger.
"We are going to continue to weigh all those different elements and certainly if our opinion or recommendation changes, we'll communicate it at that time."
Léger stressed he believes masking is an important part of the response, however, and will help reduce transmission.
He noted he now regularly wears a mask indoors, even though he doesn't consider himself to be at high risk.
Anyone with symptoms who can't stay home should "absolutely" wear a mask in public, even if their symptoms are only mild, he said. They should also consider masking at home to protect the people with whom they live.
Once people are well enough to leave their homes, they should continue to mask for at least five days when in contact with others, he said.
New Brunswick situation
New Brunswick has seen increasing flu case counts, positivity rates and outbreaks in recent weeks, said Léger
The season also started earlier than the usual late-December or January.
It's unclear whether it will be particularly worse than others, or whether we'll see more than one wave of activity due to the early start, he said.
The respiratory syncytial virus, or RSV, which mostly affects infants and young children, has also started unusually early.
"We believe that part of the reason is that we have a fairly large group of young kids who wouldn't have been exposed to this virus early in life due to the measures in place during the pandemic. Now all of these kids are being exposed at the same time, which means a lot of children are sick at the same time," said Léger.
He noted it's not a new virus and is actually a very common one, affecting almost all children by the age of two.
RSV infects the lungs and respiratory tract. For most people, RSV leads to cold-like symptoms such as runny nose, cough and fever. But it can result in severe infection in some people, including children under two and older adults with pre-existing conditions.
COVID-19 activity is on the decline in the province right now, said Léger. "but we know it will increase again, most certainly later this fall or winter."
'Significant' and 'severe' increases at hospitals
The Horizon Health Network is seeing "significant increases" in the volume of patients presenting to its emergency departments with "severe" symptoms of respiratory illness, including "a number" of young children, according to Dr. Serge Melanson, the clinical lead of emergency services and an emergency physician at the Moncton Hospital.
From Nov. 1 to Nov. 15, a total of 38 patients were admitted to Horizon hospitals with lab-confirmed RSV, he said.
"While our health-care workers are dedicated and resilient, a number of our hospitals are currently at or near capacity and many staff are out sick," Melanson said in an emailed statement.
He encourages people to get their flu shot, ensure they are fully vaccinated against COVID-19, and follow the basic pandemic protective measures.
On Friday, Horizon issued an advisory, urging people to consider their health-care options before presenting to an emergency department this weekend, citing reduced capacity due to "critical staff shortages."
Emergency departments are always available for emergencies, such as discomfort or tightness in the chest, signs of stroke, unusual shortness of breath, a child with prolonged diarrhea or vomiting, and a baby under six months with a fever of 38C or higher.
But for non-urgent medical needs, people should call Tele-Care 811, visit an after-hours clinic, consult with a pharmacist or booking a virtual appointment through eVisitNB.ca.
At the Vitalité Health Network, the number of patients hospitalized with respiratory illness is "generally comparable" to levels seen prior to the COVID-19 pandemic in 2019-2020, according to Dr. Natalie Banville, senior vice-president of clinical programs and medical affairs:
But there's been an increase in hospitalized cases and emergency room visits in children in recent weeks, she said.
"The severity of symptoms is also more pronounced than usual."
She also encourages people to get their flu shot and ensure they're fully vaccinated against COVID-19.
WATCH | Mask mandate needed indoors to protect hospitals, says pediatrician:
Léger held the briefing after facing criticism from the opposition Thursday. Liberal health critic Rob McKee, the leader of the Official Opposition, and Green Party health critic Megan Mitton demanded to know during question period why he has not being available for public briefings for the past several weeks.
CBC has not been able to get an interview with him about the weekly COVIDWatch reports since Oct. 11, and the Department of Health did not make anyone else, such as the acting deputy chief, available.
Léger said he's been "extremely busy."
He's been filling in as chief medical officer of health for Dr. Jennifer Russell since late September, when she confirmed to CBC she was on temporary leave, dealing with a recently diagnosed medical issue, while also fulfilling some of his regular duties as acting deputy chief medical officer of health.
He also got married in September and went on his honeymoon in October.
"Having said all this, I recognize that public communication is a very important part of the job, and it's one that I do take seriously.
"As acting chief medical officer of health for this province, I promised New Brunswickers that I would speak to them directly when there are important issues to share with them, and that's why I'm here today."
Asked why he decided to only address reporters rather than hold a public news conference like many of his counterparts across the country, Léger did not answer directly.
"We've been talking about … making myself available to speak to New Brunswickers and [answer] questions for you all. And so I feel that that's what we're doing here today is providing an update and providing information hopefully that will be useful to New Brunswickers."