Thanksgiving Weekend Update

October 8th, 2022

Canadian Situation:

Canadians could be in a better position ahead of this holiday weekend. Unfortunately, the premature lifting of public health protections like masking and the failure to invest in indoor air quality has led to higher rates of infection compared to Thanksgiving weekends of past years.

Bill Comeau updates on twitter, see link below.

More cases compared to Thanksgiving weekend 2020 & 2021

Cases are currently much higher, which is concerning as we usually see cases take off after the Thanksgiving weekend (see graph above). With no protections in place, kids in school, less testing/surveillance, and with new variants being detected, this may set us up for a difficult fall. This coming at a time where more kids than ever are getting sick, healthcare/frontline workers are exhausted, and hospitals across the country are above capacity with some emergency rooms shutting down. Every resident in Canada needs access to health services at some point: preventing Covid infection/related illness is one of the best things we can do to keep healthcare running and support our healthcare professionals.

Shorter re-infection time with omicron variants.

There had been some information sent to some schools in Atlantic Canada suggesting that reinfection wasn’t possible or likely within 90 days: THIS IS INCORRECT FOR OMICRON. We know re-infections can occur with several weeks and a recent study has shown that these quick re-infections aren’t a rare occurrence.

https://www.medrxiv.org/content/10.1101/2022.09.13.22279912v1

The graph above shows that a significant number of re-infections occur less than 10 weeks following the last Covid-19 infection. It also shows that the BA.2 variant represents a lot of these quick re-infections. The weekly variant breakdown in the table below shows that BA.2 is the fastest growing variant in Canada right now. While it represents a smaller proportion in this table, it is important to remember that this represents swabs collected 3-4 weeks ago. There is usually a 3 week turn around when sending samples to the National Lab in Winnipeg to be sequenced.

The good news is that having this information means that we are in a better position to take what precautions we feel necessary for ourselves and our families.

Atlantic Provinces:

New Brunswick
New Brunswick has seen infections go up to about 1250 per day with a slight decrease in daily hospital admissions, no change in ICU admissions, and 2 people are dying every 3 days. About 50 people a day get infections which will prevent them from engaging in normal daily activities for at least a month: in total, this represents about 1.3% of the population. Hospitals are about 2% overcapacity, Covid-related health expenses are about $127,000 a day, and about $108,000,000 has been spent so far this year.

The Covid Risk Index is currently MODERATE.
Newfoundland & Labrador
Newfoundland and Labrador has seen infections go up to about 350 per day with an increase in daily hospital admissions, an increase in ICU admissions, and 1-2 people are may die this month. About 32 people a day get infections which will prevent them from engaging in normal daily activities for at least a month: in total, this represents about 0.2% of the population. Hospitals are less than 1% overcapacity, Covid-related health expenses are about $36,000 a day, and about $72,000,000 has been spent so far this year.

The Covid Risk Index is currently ELEVATED
Nova Scotia
Nova Scotia is in a far worse position with infections increased to about 4,500 per day with a slight decrease in daily hospital admissions, an increase in ICU admissions, and about 3 dyning every 2 days. About 162 people a day get infections which will prevent them from engaging in normal daily activities for at least a month: in total, this represents about 2.5% of the population. Hospitals are about 5% overcapacity, Covid-related health expenses are about $435,000 a day, and about $127,000,000 has been spent so far this year.
Despite having similar issues with staffing challenges, residents without a family doctor, and resource management issues as other Atlantic provinces, NS consistently shows the worse infections rates extended over the last 6 months (even compared to the rest of Canada).

The Covid Risk Index is currently ELEVATED.

Prince Edward Island
PEI has seen infections go up to about 1028 per day with an increase in daily hospital admissions, an increase in ICU admissions, and 1 people dying every 5 days. About 33 people a day get infections which will prevent them from engaging in normal daily activities for at least a month: in total, this represents about 2.2% of the population. Hospitals are 6% overcapacity, Covid-related health expenses are about $88,000 a day, and about $18,000,000 has been spent so far this year.

The Covid Risk Index is currently ELEVATED

Actions we can take to stay safe this Thanksgiving Weekend.

Harvard’s School of Public Health put out a great guide to gathering safely during Thanksgiving which can be found HERE.

Some safety tips:

  • Used Rapid Antigen Tests (RATs) before attending any event. #Test2Protect
  • Do not attend events if ill, even if RATs are negative.
  • Consider reducing you number of contacts, especially if attending multiple events.
  • Eat outside if possible.
  • Offer masks if staying indoors. #CovidIsAirborne
  • Increase Ventilation by opening windows.
  • Check indoor air quality with a CO2 monitor if possible, more info HERE.
  • Use HEPA or CR Boxes to filter the air.
  • Considering virtual or a mix of virtual/in-person so that everyone can feel safe and included.
  • Try to respect that we don’t all have the same risk factors of severe outcome or comfort level. Whatever you believe, I’m sure everyone wants their family and friends to feel comfortable and safe during gatherings. We’ve lost enough to Covid-19 already.
  • If you have concerns, try to bring them up with family before an event and discuss in terms of how you feel about your personal risk and comfort level. Try to find common ground because family gatherings shouldn’t be political. You don’t need to believe all the same things to connect: it’s just about respecting the concerns of vulnerable family members and adapting.
  • Let’s make finding common ground the #NewNormal in this era of “living with Covid”. Clean air, staying home if sick, and staying socially connected with loved ones is something most everyone can agree on. #StaySafe!

The Nova Scotia Pediatric Pandemic Advisory Group Letter:

An Open Letter to Nova Scotia Parents and Students, September 6th, 2022.

“As we prepare to return to school this fall, we know that questions about how best to protect students, teachers, and families/caregivers are being asked. Schools, like hospitals, provide an essential service. Students and educational staff need to be healthy and able to attend so that all can benefit.

During the past 2 ½ years, we have learned a lot about what works to decrease respiratory illnesses including COVID-19, influenza and the common cold. We need to use what we have learned and work together as we begin another school year to reduce the spread of COVID-19 and other respiratory illnesses.

Masking, vaccination and hand washing have been cornerstones of the pandemic response and have proven effective in reducing transmission of infections. While it is reasonable to relax some of the recommendations that were crucial during earlier waves of COVID-19, masks, vaccines and good hand washing remain our best tools to fight the spread of infection.

Masks: Masks do reduce transmission of COVID and other respiratory viruses. We recommend wearing masks in the school setting when students or teachers:

  • are mildly unwell (i.e. runny nose), but still able to attend school.
  • are in close contact with someone who has respiratory symptoms who can’t wear a mask.
  • are worried about potentially bringing home respiratory viruses to family members or loved ones who are at higher risk of becoming severely ill.
  • feel more comfortable wearing a mask for any reason.

What else can help?

  • Make sure you and your family receive all recommended COVID-19, influenza and other vaccinations.
  • Stay home from school/work if you are sick and/or experiencing cold or flu-like symptoms, including fever, vomiting or diarrhea, or new cough.
  • Use good hand washing practices, including after returning home from being out in public, before eating, and after toileting.

Finally, it is important to ensure that students are not bullied about whether they do or do not wear a mask. Discuss this with your children. Be kind to one another, and tough on viruses.

Nova Scotia Pediatric Pandemic Advisory Group:

Dr. Alexa Bagnell (IWK Chief of Child & Adolescent Psychiatry)

Dr. Tara Chobotuk (IWK Pediatric Emergency Medicine and Chief of Community Pediatrics- Central Zone)

Dr. Jeannette Comeau (IWK Pediatric Infectious Diseases Specialist and Medical Director, Infection Prevention & Control)

Dr. Joanna Holland (IWK General Pediatrics & Hospital Medicine)

Dr. Katharine Kellock (Community Pediatrician- Sydney)

Dr. Mike Nash (Chief of Pediatrics- Valley Regional Hospital, Kentville)

Dr. Sarah Shea (IWK Developmental Pediatrics)

Dr. Andrew Lynk (IWK Chief of Pediatrics)”

Infection Prevention and Control Considerations for Schools

Briefs of the Ontario COVID-19 Science Advisory Table.

“In-person schooling is essential for children and youth for both academic educational attainment and for the development of social, emotional growth and life skills. Schools are a place where children gain essential academic skills, form friendships, learn social and life skills, and are key settings for physical activity. Schools provide critical services that help to mitigate health disparities, including school nutrition programs, public health services (immunizations, dental screening), health care services (speech and language therapy, occupational therapy), social services and mental health supports. Schools should therefore remain open for in-person learning.

Optimizing the health and safety of children and staff in schools requires that certain health and safety measures be in place, irrespective of the COVID-19 pandemic. These “permanent” measures include achieving and maintaining adequate indoor air quality, environmental cleaning and disinfection, hand hygiene, students and staff staying home when sick and up-to-date routine and recommended immunizations for students and staff. 

Temporary infection-related health and safety measures (e.g., masking, physical distancing, cohorting, active screening, testing) can help reduce the transmission of communicable illnesses in schools. However, some can pose additional challenges to school operations, student learning and student wellness. Furthermore, some of these measures may adversely impact social connectedness, which is of vital importance for children of all ages and of heightened significance in the adolescent years. Therefore, a thoughtful approach based on real-time local level analysis is recommended before reintroducing these temporary measures after careful consideration of the potential benefits and negative consequences. Given that schools are not isolated from communities, implementation of these temporary measures should not be done in isolation of community measures for indoor spaces. These temporary measures are not expected to be required at the start of the 2022 school year.”