By now Canadians should know that the infection rate of COVID-19 is not a bad thing. In fact, the rise in the infection rate is good. It’s the death rate we have to watch and we are watching it. The infection rate needs to increase in order to achieve immunity.
We have to stop thinking of a COVID infection as if it were terminal cancer. We know that half the population has no symptoms when infected. For most others, infection is like having the flu.
The rate of death from COVID-19 is so low that most people can and should be allowed to go about their business. A group of Canada’s infectious disease experts agree. Last month they penned an article telling Canada that “it’s time to lift the COVID-19 lockdowns.
The experts are Dr. Neil Rau, an Oakville infectious diseases specialist and medical microbiologist in private practice and an assistant professor at the University of Toronto; Dr. Susan Richardson, a retired infectious diseases physician and medical microbiologist and professor emerita at the University of Toronto; Dr. Martha Fulfor, an associate professor at McMaster University and an infectious diseases physician at Hamilton Health Science; and Dr. Dominik Mertz, an associate professor at McMaster University and an infectious diseases physician and hospital epidemiologist at Hamilton Health Sciences.
Here are excerpts from their commentary that appeared in the National Post.
Has the lockdown worked?
In Canada, we can rightfully say that we were able to “flatten the curve” to avert a northern Italy or New York City scenario. Now we face the unintended consequences: Delays in medical care for non-COVID-19 patients, educational impacts, the looming pandemic of mental-health issues, and massive economic repercussions. Widespread restrictions certainly cannot be sustained until an effective and safe vaccine is widely available, which may not occur for years, if ever.”
So, the lockdown was a success?
Yes and no. Success in “flattening” the outbreak curve permitted the health-care system to handle the surge in cases safely and to avoid unnecessary deaths. But, we were not successful in protecting the elderly and frail population in nursing homes, where roughly 80 per cent of Canada’s deaths occurred.
Who is at risk of dying from COVID-19?
It is important to point out that more than 95 per cent of COVID-19 deaths occurred in those over 60, compared with none under age 20. Protection of the former group deserves the most attention; this will be easier if limited resources are diverted from other, low-risk groups.
In Canada, the individual rate of death from COVID-19 for people under 65 years of age is six per million people, or 0.0006 per cent. This is roughly equivalent to the risk of dying from a motor vehicle accident during the same time period.
In other countries where data are available, 0.6-2.6 per cent of deaths in people below age 65 have occurred in people without known underlying health conditions.
Is a vaccine coming?
It is entirely possible that in two years we will still not have a vaccine, and very probable that a vaccine will not eliminate the virus entirely. Hence, we need to come to terms with the fact that we cannot eliminate this virus. At best, we can continue to slow its spread, and protect the frail and elderly.
As the economy re-opens, and with more testing there could be a spike in infections. Then what?
We will find cases that would previously have gone unnoticed. Ironically, the better our testing capacity and the more we look, the more we will find, making it appear that disease is worsening, when it isn’t. This is particularly problematic as restrictions are being lifted.
Should we automatically reinstate restrictions when the number of cases increases? No. Instead we should use local hospital capacity as the guiding principle, ensuring that all patients who need hospital or ICU care can get it.
Sweden has more cases per capita but kept its economy open? Were they right?
More deaths per capita did occur than in Canada. On the positive side, Sweden’s number of new cases has peaked and Sweden will be better protected against future waves and the need for future restrictions. In the absence of a vaccine, it is a question of paying now or paying later.
While the realistic goal of Canada’s lockdown was to delay deaths, it was never going to avoid them entirely.
One year from now, Canada and Sweden may well have the same number of deaths per capita, but Canada may have had significantly more economic and social impacts.
What should Canada have started doing by mid-May?
In the absence of hospital strain, consider continuing with a swift release of lockdown measures, to include opening of elementary schools, playgrounds, workplaces, stores and restaurants, while following basic physical distancing rules and voluntary limitations to social gatherings, while continuing to ban mass gatherings and protecting the elderly and those at highest risk.