Back to school, back to sickness? York Region's medical officer of health discusses new COVID-19 variants, new vaccines, and how to prepare for fall

Is another 'tripledemic' on the horizon?

yorkregion.com
Aug. 18, 2023

Don’t panic. Prepare.

That’s the advice from public health as we move into fall and another season of sickness.

Health authorities are detecting a new, possibly more transmissible COVID variant just when kids are returning to school and cooler weather pushes us indoors.

It may be time to ramp up the vigilance and precautions again.

Some parents and teachers worry we’ll face another tripledemic similar to what we experienced last fall with flu, RSV and COVID-19 and wildfire smoke causing worse illness.

They are urging the province to protect kids with better air quality in schools and buses.

A study published in June in Journal of the American Medical Association Network Open suggests children are important viral vectors; when school was in session, it accounted for 70 per cent of household case transmissions.

"Clean air in schools and schoolbuses is the path to less illness elsewhere," said Mary Jo Nabuurs, an Aurora resident and one of the founders of Ontario School Safety that sent an open letter to the Ontario government asking them to address the issue.

Dr. Barry Pakes, York Region’s medical officer of health, said it has been a relatively quiet summer on the COVID front.

Cases soared in early spring, with many hospitalizations and deaths, then dropped to the relatively low level we saw in 2020 after the big lockdown, he said.

“However, we are seeing signs in the wastewater of it increasing again ... We’re definitely carefully watching.”

The fall of 2022 was particularly challenging with a variety of viruses circulating, Strep throat and invasive Strep was prevalent in the spring and even, this summer, people noticed cold and flu still making the rounds.

But that’s to be expected, an after-effect of the lockdown and social distancing, Pakes said.

Now, wastewater is showing an uptick in COVID again.

“People are not getting really severely ill at this point, and we’re not seeing an increase at all in hospitalizations, but that is increasing very slightly now.”

There is good news.

Public health monitors what’s happening elsewhere in the world and, in particular, the respiratory season in the southern hemisphere, which often predicts what’s ahead for us in the fall.

Right now, in South America and Australia, it is not a bad season for RSV and influenza and the flu vaccine for the upcoming season appears to be a good match, he said.

As well, the new Omicron variant, EG.5 or Eris, spreading quickly around the world and currently more than a third of cases in Canada, does not appear to be more severe.

“We’re not awfully worried about it ... but if it starts building and becomes quite significant through the fall, then that, combined with everyone getting back together inside and flu and RSV ... there is potential for a more severe season and that’s what we’re always preparing for.”

And no, it’s not "just a cold," Pakes said.

“It can be incredibly severe for many, many people and deadly for many, many people.”

While mask mandates are unlikely to return, Pakes said those who are vulnerable to respiratory infections, older or with comorbid conditions would be wise to resume masking (N95s are recommended).

It’s also a good idea to mask in health care settings, he said.

“Masks remain in many clinical settings, particularly in hospitals with vulnerable people, and I think that’s going to be a seasonal approach.”

It’s also important to mask if you must go out while you have any symptoms --- but the best practice, he said, is to stay home when ill.

“You can cause someone to go into hospital and potentially even worse just by passing them if you’re having symptoms and sneeze.”

The new monovalent Omicron-related vaccine offers more hope, and if you haven’t had a vaccine in the past six months and are poised to get one now, it’s best to wait for this new version for maximum protection, he said.

It’s expected to roll out as early as September and should protect you for the entire respiratory season, he said.

While it’s true earlier vaccines have waned, if you're vaccinated and had COVID-19, are not immunocompromised and under age 65 and decide to wait for the monovalent, “you’re probably well protected from getting really, really ill.”

And if you’re a parent, he adds, make sure all your child’s vaccines are up-to-date, and the information inputted into the provincial system.