Fire up the summer with vaccination...

As Alberta moves to removing pandemic restrictions, thoughts of BBQ, optimism and caution come to mind. Covid-19 continues to burn through parts of the world and smoulder in our local community. We’ve all done a great job at reducing the fire spread by keeping matches away, even if we feel the pinch of our right to light up. Some have been left in the cold or the dark without our matches, but the burn rate for Covid has been higher than the average annual fires we’ve seen in past flu seasons.

Infections rates have been up and down, but it is hospitalizations that are critical. First, it makes sense that the sickest people get admitted to hospital. Second, hospital resources are not unlimited, and in fact, the majority of a hospital’s service is lower to medium illness (simple emergencies, testing, surgeries, transfusions, etc). Third, a small amount of hospital services are very resource costly such as the post-surgery recovery, heart units, cancer treatments and intensive care. These areas require 24/7 specialized teams, equipment and support (meds, supplies, cleaning, etc). Fourth, usually the ICU has a stay time of 2-3 days before being stabilized enough to transfer to a less intense bed. When there is a surge, some post-surgical and heart beds can be converted to ICU beds, and the specialty teams can be bolstered for a while. Fifth, the average length of stay for an ICU Covid patient is 6-10 days. This increases the need to convert other beds, and blocks those services from using them, and further trickles down to the rest of the system in manpower and supplies. Of course, we are all aware of the slow down in services of all sorts…all because the top intensive part of the system is overloaded. Reducing need for ICU beds means getting the underlying community infection under control.

Vaccinations have been instrumental in moving towards greater protection, less spread and opportunities to re-open. Full 2-shot vaccination is around 30% in Alberta (>90% protection from hospital-level infection) and 70% for 1-shot (~60% protection). While we wish for 100% vaccinations, it is reasonable to assume well only get to 75% full. Keep in mind that this does not include under age 12, which is 20% of our population. This means that 75% vaccination of 80% of Albertans by the Fall will protect just over half (60%) our population. The vaccines are safe and effective. They do not contain 5G chips, cannot change your DNA, do not cause autism, and generally do not have side effects worse than getting the virus itself. With regard to the Astra Zeneca vaccine, the rare clot rate of 20/million does not compare to the 500 clots/million from contraceptive pills or 1500 clots/million from smoking or 10,000 clots per million from Covid-19. We spend far too much effort worrying about potential ill-effects of the vaccines without weighing the potential ill-effects of no vaccine; Covid infection may have upwards of 1000 times greater likelihood of side-effects.

The unvaccinated half of our population will continue to be a source of tinder for the virus to smoulder in. And given the higher transmissibility of the current delta variant (9% of our infections), it may overtake the alpha variant (60%) as the dominant strain. This means faster spread ensures the fire being entrenched. Unlike fire though, viruses are reproducing organisms. Like all organisms, they reproduce and mutate (we each have some differences from our parents, siblings and kids). The larger the pool of virus and the longer it has to replicate, the greater the chance a mutation will come along that is of lower harm. Coronavirus has been around forever, making up about 20% of our annual colds. However, 2 other coronavirus mutations proved to be frightening- SARS in 2003 and MERS in 2012. Depending on one’s conspiratorial leanings, Covid-19 emerged in 2019 (or late 2018), and because of its worldwide spread as well as persistence, we could speculate that it has its own branch to mutate from.

From a physician perspective, we have been working and living under a non-sustainable heightened level of hyper-vigilance for 18 months. We have been fortunate not to get sick, have a job and kept our families healthy. We have had our challenges of losing our previous clinic due to Covid related business reduction, wearing PPE more than most, and keeping ourselves and our families apart to maintain our capacity to be there. This we do not lament, as it is our calling. But we don't want to sacrifice the efforts of the past year by reducing our vigilance too quickly, and lose the side lessons of increased hygiene (less cases of colds, flus, pneumonias and food poisoning for example).

All of this in mind, get vaccinated, be vigilant, be optimistic and let's make the only fire be in the BBQ this summer.