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Monday, August 8, 2022
Dr. Brown: Here we go again: Another wave of COVID hits home
Dr. William Brown.
Dr. William Brown. File

Just when most people have happily returned to life without a mask and social distancing, a mini surge in COVID cases involving variants of Omicron is sweeping across Canada.

Some of those cases involve residents and staff in long-term care, but most pass undetected because they’re asymptomatic or no testing was done.

Similar canaries in the mine occurred in the early days of the U.K. and Omicron waves and are part of the now familiar pattern with how this virus behaves.

First a review. In late 2019, COVID (SARS-CoV-2), swept through China and much of the world and was followed by successive waves of variants of the original virus, of which the latest variants are versions four and five of Omicron.

The original Chinese variant in late 2019 and first half of 2020 spread rapidly and led to many deaths in populations unprotected by vaccines, and especially among the elderly and those unable to mount effective immune responses.

The widespread adoption of contact tracing, social distancing and wearing masks managed to “flatten the curve” for much of the latter half of 2020 by effectively slowing the spread of the disease and reducing the impact on overwhelmed acute care facilities.

However, falling case numbers and news that effective RNA and other vaccines were on the way, created a false sense of security in the late fall and Christmas season of 2020 – just as the U.K. variant struck.

Soon case numbers skyrocketed, ICUs were full again and later-than-hoped-for vaccine deliveries meant this more highly contagious and possibly lethal variant, hit hard, especially those in long-term care facilities, the elderly and anyone who was immunocompromised.

Unfortunately, the highly effective RNA vaccines weren’t available until mid-February – too late for many.

Fortunately, when the even more transmissible and possibly lethal Delta variant arrived in the spring of 2021, most people had received their first shot of an effective vaccine and within another three to four months their second shot.

This all happened without much of the drama and formidable resistance of the antivaccination campaign that would later hobble vaccination programs, especially in the United States, but also in Canada and parts of Europe.

Mid-2021 saw another ominous note, the growing awareness that immunity even with the best vaccines, began to wane three to four months following the second dose.

This prompted first Israel (where the initial study was done), and soon other countries, to offer a booster shot and later, for much the same reason, a second booster, again with the original vaccines.

With the coming of effective vaccines and continuing distancing and masking, numbers again fell in the fall of 2021, only to explode once more over the holiday season. This time the cause was a far easier to catch variant called Omicron, which proved to be much harder to keep out of long-term care facilities.

Fortunately, for the great majority who had received their primary and first and second booster shots, few became sick enough to require hospitalization.

For the unvaccinated, however, the high numbers of cases meant acute care facilities, particularly in the United States, were often overwhelmed before case numbers finally began to drop.

These days, theatres, restaurants, and bars are open without restrictions – the first truly good news for most of us in close to three years.

The trouble is that Omicron has continued to evolve and the vaccines are now clearly outdated.

This raises the spectre of a new wave, again in the late fall and early winter when people are inside once more, but this time not masking or distancing and protected by less-effective vaccines.

That’s the bad news that few, except the U.S. Food and Drug Administration, are talking about.

The good news is that the manufacturers of the RNA vaccines have developed updated vaccines that are effective against Omicron variants.

The not-so-good news is these vaccines will not be available until October at the earliest and possibly several months later if delays in scaling up and distribution occur as they did the first time around.

That means this winter we will be under-protected by outdated vaccines, wide open as far as public health measures go, and facing later versions of Omicron or possibly a brand-new variant we haven’t heard of yet, just as we faced the original Omicron variant a year ago.

That one stunned everyone last holiday season and winter.

That’s the worry for the fall and even this summer, if the current mini surge turns into a much larger wave of cases.

There’s another worry too – whatever happened to the idea of developing a universal vaccine?

The FDA and Dr. Anthony Fauci thought the idea was very promising and possibly the only way to get ahead of this virus. Was it complacency and a shortage of funds, what with the U.S. Congress so divided and the war in Ukraine?

And Canada – what have we done to develop vaccines?

Dr. William Brown is a professor of neurology at McMaster University and co-founder of the InfoHealth series at the Niagara-on-the-Lake Public Library.