Are we making mistakes? York Region's top doctor talks about schools, businesses, variants and vaccines

5 questions for Dr. Karim Kurji about COVID-19 and what we can expect now

Yorkregion.com
Feb. 9, 2021

1. Is Ontario making a mistake in opening schools?

There has been considerable amount of thought put into this area over a number of months and the protocols have continuously been revised to make schools safer.

With the variant present in the community, we have introduced tougher screening and additional layers of testing. In addition to targeted asymptomatic testing, we are exploring the possibility of multiple rapid tests in those who have one symptom to reduce the time students must be out of school and reduce pressure on parents.

We have always found that the danger was in students acquiring COVID-19 in the community and bringing it into schools, rather than the transmission within schools. Generally speaking, our schools have been very safe. If we all work together and keep cases going down, which we have been successfully doing, this should reduce the risk of children bringing it into schools.

2. Why open schools and not businesses?

We have put in many layers of protection for schools that do not exist with the business community.

In addition to what we were doing previously, we are doing more stringent screening and a lot of testing. When there is a case, we dismiss the entire cohort in order to try and determine where the infection was acquired and to keep everybody in the cohort safe.

This is quite aggressive and it’s not the sort of management that we use in the business community.

If you were to use the same protocols in businesses, that would essentially mean that the store would be closed for 14 days the moment we have a case enter a retail establishment and they would all need to be in self-isolation for 14 days. This is way above what we normally practice. The operationalization of that is huge and would require tremendous resources.

3. When can we expect more vaccine supplies and how long will the vaccines’ protection last?

We expect in Ontario to have a lot more vaccine toward the end of March. This is why we’ve been stepping up our preparations for mass immunization clinics. We are preparing for a scenario where, if we were given 50,000 vaccine doses tomorrow, we could have a mass immunization clinic ready within a matter of days.

It’s not certain yet, but the expert opinion generally is that the immunity should last at least a couple of years. I do not think that we will need booster doses on a yearly basis. A lot depends on the evolution of the virus.

We may see different variants from the ones we already know about from any place in the world where the virus continues to multiply. If new variants arise, the good news is that the technologies we have with respect to the mRNA vaccines means new vaccines can be produced relatively rapidly.

4. How does the variant affect herd immunity?

We have been aiming to get vaccine coverage of at least 70 per cent in our population to build herd immunity. Should the variant become the dominant strain, we would need to build up vaccination rates to around 85 per cent.

Based on our current experience in long-term-care homes, staff have only been accepting the vaccine to a level of between 50 and 69 per cent. There is a lot of work going on right now with respect to this vaccine hesitancy.

5. Given the variants, should we be double-masking or wearing N95s?

Public Health Agency of Canada generally recommends a three-layer mask; however, there are experts in the U.S. suggesting double masks.

The more layers you put on, the better protection, but there is the issue of breathability and fit. If adding more layers makes it difficult to breathe, that is a compromising situation.

We will continue advocating properly fitting two or three-layer masks until there is some clear science, based on the variants, that alters that.