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Weathering the storm: Atlantic Canada will see a resurgence of COVID, but experts say we can pull through with the right moves

Bonavista is usually a busy destination for tourists coming to Newfoundland and Labrador, but its main streets generally remained quiet this past week. — BARBARA DEAN-SIMMONS/SALTWIRE NETWORK
Bonavista, N.L. is usually a busy destination for tourists coming to Newfoundland and Labrador, but its main streets generally remained quiet during the COVID-19 pandemic. All that could change on July 3with the Atlantic bubble, but experts wonder if we may become too complacent. - SaltWire file photo

With case numbers low or non-existent, the economy slowly reopening across the region, social distancing restrictions being relaxed and even plans to allow travel within and to the Atlantic provinces, life is starting to feel a little more normal for many East Coasters.

This might leave people wondering — is the coronavirus a thing of the past or is this just a temporary lull, with the rumoured second wave looming menacingly in the distance?

According to experts, the COVID-19 pandemic is far from over, but some things can be done to ease the second wave and better weather the storm.

Mary Jane Hampton, healthcare consultant and Nova Scotia's former commissioner of health reform said she believes it's inevitable we will see a resurgence of the virus in Atlantic Canada.

“This isn’t over ... and to think this is over is a very dangerous and foolhardy position to take,” she told Saltwire.

“It feels to me like we're in the eye of the storm — it's that kind of unnerving quiet that you really wish it was done, but you know pretty intuitively that there's going to be something else that's coming up behind.”

Susan Kirkland is a professor and head of the department of community health and epidemiology at Dalhousie and a member of the national COVID-19 immunity task force. She said while we can't predict exactly what's going to happen, some clues can be gleaned from past pandemics and how the virus is behaving in other parts of the world.

“What we know is certainly in other pandemics like H1N1 or the 1918 influenza what we see is a second wave and we see a very serious second wave,” she said.

The rate of infection is very low in Atlantic Canada, meaning that without a vaccine whatever immunity that could exist in the population likely doesn’t, and Kirkland said this sets the stage for a strong second wave, likely starting in late fall or early winter.

She said a resurgence of COVID-19 can take two forms. The first is a resurgence of underlying virus caused by travel and relaxed restrictions.

“There are definite challenges related to travel — if all of a sudden we start moving around again, we're going to see more cases,” Kirkland said. 

Then there’s a true second wave — the likelihood that the virus never truly goes away and continues to live in the environment, popping up again when conditions are favourable in the colder months, when more people are socializing indoors and people’s immune systems are already compromised by the resurgence of other seasonal viruses.

“Flus, for example, tend to wane off in the early spring but then every single year the flu comes back, well where does it come from? It’s probably there all the time but the situation for its spread is not as conducive,” Kirkland said. “The reality of it is there's a large seasonality and it has to do with factors in the environment as well as factors within us.”

“I would hope that we've learned enough not to repeat it but there is no short term solution in long-term care, it is a long-term problem.
We're going to have to act very quickly.”

Weak links

While both Hampton and Kirkland agree Atlantic Canada is better positioned than some parts of the world to weather a second-wave pandemic due to factors like a low population density, some things make us more vulnerable such as our aging population and the rural landscape spreading health resources more thinly than other parts of Canada.

Kirkland said it’s important to ensure the virus doesn’t spread to rural communities as their healthcare systems are not equipped in the same way the larger centres are. Avoiding outbreaks in long-term care homes, where the majority of serious cases and deaths and in Atlantic Canada have occurred, will also be key to protecting the most vunerable and reducing spread.

“I would hope that we've learned enough not to repeat it but there is no short term solution in long-term care, it is a long-term problem,” she said. “We're going to have to act very quickly.”

Another weak link, according to Hampton, could be in keeping up contact tracing due to understaffed public health sectors. In Nova Scotia, for example, Hampton said there are only about two dozen people committed to full-time public health work.

“Not only have they had the weight of public expectations but they also have the burden of quite literally needing to protect a million lives and they're exhausted,” she said.

The kind of work done in public health such as contact tracing, which Hampton said is crucial to managing spread of the virus, is a hugely labour-intensive and a highly developed skillset that’s not easily transferable to new hires.

“If they stumble in their ability to support the vigilance in the contact tracing and updating of evidence-based protocols for the public to use, we're sunk,” she said. “So at some point, we need to figure out how to bolster our public health assets so that they can ride the wave.”

Hampton also said she’s worried about impatience, both within people’s normal lives leading them to become complacent with the rules and restrictions, but even more crucially within the healthcare system where there is a backlog of planned and elective procedures that were put on hold during the first wave.

“There will be an intention to ramp the mainstay health system back up, possibly too quickly, and if we start to take up all the operating room and intensive care beds with other needs we could get swamped by the second wave,” she said. “We need to manage that tension and continue to manage the public's expectation in that regard and not let our guard down.”

“We just have to prepare as if it is going to happen, the worst-case scenario, if it doesn't happen, is we've over-prepared."

Staying vigilant

Kirkland said it's crucial as we start to relax some restrictions that Canadians stay vigilant in areas such as hand washing, social distancing with people outside of your bubble, and mask-wearing in public. She also said continuing to do widespread testing to detect new outbreaks and keeping travel to and from places with high rates of infection to a minimum (and ensuring people self-quarantine when they do travel) is also important.

In general, Kirkland said, the fact that we have had time to prepare and doing so will serve us well in the event of a second wave

“We just have to prepare as if it is going to happen, the worst-case scenario, if it doesn't happen, is we've over-prepared,” she said.

As people begin to see the numbers climb in a few months, Hampton is concerned that Canadians will become resigned to the fact that the virus cannot be stopped and give up, which she said could have dire consequences.

“Look at what can only be described as the apocalypse happening south of the border ... that's not a future we need to embrace, but if things start to get ugly I think the same resignation we're seeing (there) could be reflected in Canada,” Hampton said.

“We did such a good job of protecting ourselves from the first wave to be in the eye of the storm and then (to) get wiped out as it comes through the second time around would be the ultimate tragedy.”

Twitter: @notandrea

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