Learning to live with COVID: why some experts say it's time to 'manage' the virus

·5 min read
Students wear masks on school grounds in Vancouver on Friday, October 1, 2021.  (Ben Nelms/CBC - image credit)
Students wear masks on school grounds in Vancouver on Friday, October 1, 2021. (Ben Nelms/CBC - image credit)

The lightning-fast spread of the Omicron variant is prompting some of the country's top public health officials to rethink their approach to COVID-19 — and to acknowledge that Canadians should get used to living with the virus.

One of them is Dr. Robert Strang, Nova Scotia's chief medical officer of health.

"At some point in time, we are going to have to say we have to move away and accept that the virus that causes COVID is going to be around with us," Strang said in an interview airing Saturday on CBC's The House.

Strang said the goal should be to "manage" COVID-19 "based on having good levels of immunity from both vaccination and infection ... [so] that we no longer have to have these wide restrictive measures and have this huge focus of trying to identify as many cases as possible."

That's a significant departure from the approach most governments have taken since COVID-19 emerged in Canada nearly two years ago.

The proven potency of vaccines is one reason we're having this conversation now — but Strang also said Omicron is so pervasive that everyone needs to recognize that it may no longer be possible to avoid.

"No matter what our age is, if we're out and about and in our communities, there's a strong likelihood that we're going to be exposed and may well get COVID. We have to accept that reality," he said.

'It can't be stopped'

Strang isn't alone. His counterpart in Newfoundland and Labrador, Dr. Janice Fitzgerald, offered the same view at a news conference earlier this week.

"The reality of this virus is that it is so infectious most people will acquire it," she said. "But our health care system can't withstand the pressure of everyone acquiring it at the same time."

So the focus now appears to be on managing the spread, rather than containing it.

Chris Young/The Canadian Press
Chris Young/The Canadian Press

Ontario Premier Doug Ford this week reintroduced health restrictions, moved classes back online for two weeks and paused non-emergency surgeries. The measures, he said, are intended to slow down Omicron as much as possible.

"I say slow the spread because it can't be stopped," he said. "Looking at other countries, other provinces, it's too contagious to stop completely."

The idea of herd immunity was floated in the past by politicians but abandoned as an option as case counts, hospitalizations and deaths mounted around the world.

'Population immunity'

Strang doesn't like the term herd immunity. But he said it's clear that with the emergence of Omicron, a high level of what he calls "population immunity" — infections combined with widespread vaccination — could allow people to carry on with their lives.

"But whether it's a combination of vaccine or infection, you know, we have to at some point be able to say we need to have a much more normal life and live with COVID," he told The House, "and try to find find a more balanced approach between limiting the impacts of COVID, focusing on the severe side of the illness — those who are most vulnerable — but not having all the restrictions that we have in place right now."

Chris Young/The Canadian Press
Chris Young/The Canadian Press

Canada already has one of the highest vaccination rates in the world. Nearly 85 per cent of Canadians have had one dose, while almost 78 per cent have had two. As of Friday, a quarter of the eligible population has received a booster.

But governments continue to reimpose restrictions. Quebec brought back a nightly curfew. The return to school has been delayed in many provinces and politicians remind Canadians almost daily to limit their social contacts and continue to follow other guidelines, such as social distancing and masking.

The limits of 'top-down' pandemic policy

And it all comes with the promise — again — of better days ahead.

But as Canadians grow increasingly weary of the pandemic and these on-again, off-again restrictions, many are asking if that approach is working.

Katherine Fierlbeck chairs the political science department at Dalhousie University. She's written extensively on health care policy. She said the way governments approach the pandemic needs to evolve.

"I think people get tired of top-down governance very quickly, especially when it becomes clear that the political and scientific landscape is complex and nuanced and continually in flux, and that any decisions made will lead to both winners and losers," she said during a panel discussion on The House.

"So what this means, I think, is that we need precisely the opposite of what worked earlier … What we need is [an approach] that's more transparent about the evidence it uses in making decisions, including the limitations of the data in use and more recognition of the trade-off between potential benefits and potential harms and a recognition of who the winners and losers will be with any particular policy measure."

Convincing the holdouts

University of Alberta political science professor John Church also specializes in health care issues. He said politicians should take care to avoid taking too hard a line on vaccination status because it could turn the vaccine-hesitant into vaccine resisters.

"I think the fact that the technology is emerging now, for example, a pill form that can be taken, might be a way to gradually nudge some of the undecided people to get vaccinated," he said during the panel discussion.

"But beyond that, I think they have to consistently be providing the information to the public that the people that are getting sick and are ending up in the hospital — so, the sickest people — are those who are not getting vaccinated. And beyond that, there's not a lot that can be done."

Strang said he's confident that better days are ahead — in large part thanks to the fact that the Omicron variant is so widespread.

"We know that vaccines gives you longer term and better immunity than an infection but getting infected gives you some immediate [immunity] for the near-term, along with more and more people getting their booster doses," he said.

"So that combination of the widespread [infection] and continuing to improve our vaccination coverage gives us the path."

That path could lead governments to lift restrictions and allow Canadians to go about their lives more freely. But one obstacle still remains: getting through this fourth wave, which shows little sign yet of having run its course.

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