Third dose, booster dose, fourth dose, fall dose......I am confused. Are you?

OK. Let me try to unpack this a bit. Sometimes it is a good idea to remember where you have been in order to know to where you are going. It might be time for a COVID-19 variant and vaccine history lesson.

March 2020- COVID-19 is declared a pandemic

Alpha- The first variant of concern (VOC) - December 2020. It was 20 % more transmissible than the original COVID-19 virus. It increased the number requiring hospitalized by 52 % and increased the number of mortalities by 57 %. Remember the dark days of the fall and winter of 2020 when we all spent Christmas alone or in our very tiny bubbles?

Beta- The second VOC- Jan 2021. Beta was 25 % more transmissible than Alpha but did not cause an increase in hospitalizations or deaths.

Gamma- declared a VOC in Jan of 2021 but it remained mostly localized to Brazil and South America.

Delta- The fourth major VOC- May 2021, caused a major surge in global cases. It was 97 % more transmissible than the alpha variant. Hospitalizations increased by 85 % above the alpha variant and deaths increased by 137 % above the alpha variant. This variant tortured India.

Omicron- declared a major VOC in November of 2021. This guy is interesting ( no gender reference intended). Although more transmissible than the delta variant, it caused less serious illness with a hospitalization rate that decreased by 57 % relative to the Delta variant and a decrease in mortality of 63 % relative to delta.

None of the other VOC's are circulating now. Omicron has taken over world-wide. In some ways that is good news. The new VOC's seem to be more transmissible but much less deadly. The newest offshoots of Omicron are BA-4 and BA-5. They are fuelling a global surge in cases with a 30 % increase in cases worldwide over the last week! BA-5 is the most transmissible Omicron variant so far. But, early data from South Africa has not shown a sharp rise in deaths from this sub-variant.

BA-4 and BA-5 have up to 50 more mutations ( changes on the surface of the virus) than previous variants. Twenty-six of these mutations are unique to this variant and more than 30 on the spike protein. This allows the variant to get past some of the anti-bodies we produce after vaccination or natural infection; the reason I had COVID twice in May.

The first COVID vaccines in Canada were administered in December 2020. Remember that miracle of speed and scale in vaccine production and administration? By June of 2021, half the population had received one dose. Another miracle. By July of 2021, more than half the population had received two doses and by the end of 2021 almost 80 % were fully vaccinated. Thank you for that. That national effort allowed us to cope well with both the delta wave and the first Omicron wave.

But, here we are in July of 2022 and more than half the vaccinated population have only had two doses.

https://health-infobase.canada.ca/covid-19/vaccination-coverage/

Third doses became available in December of 2021. We know that 2 doses of vaccine provides almost no protection against the new Omicron sub-variants ( BA-4 and BA-5).

My recommendations:

1/ The first and most important recommendation is that everyone who has had only two doses, get a third. That third dose of vaccine dramatically boosts your immunity and keeps you away from serious illness.

2/ If you have had three doses but your last dose was over 6 months ago and you are over 50 or have major chronic illnesses get a fourth dose this summer. Your immunity is waning and that 4th dose will boost your immunity to BA-4 and BA-5 just as we start climbing the seventh wave.

4th doses will be available to adults 18 and older in the next week or so in Ontario. Again, younger adults could hold off until the fall.

3/ If you have had three doses of vaccine and a case of COVID in the last three months, still consider that fourth dose. The early recommendations suggest waiting 3 months from your positive test. Natural infection does not protect as well as vaccination and the amount of protection provided by natural infection is not predictable.

4/ If your third dose of vaccine was less than 4 months ago and you are under 50 and healthy, you could hold off making a decision about a 4th dose until the fall when there may be an Omicron specific vaccine which is now under development.

Take home message, COVID is not gone. This 7th wave has the ability to cause serious illness and death in those at risk and to knock the last breath out of our healthcare system. Even mild to moderate illness will interrupt your life in many ways. See my last post for personal details on that!

Vaccines are still your best protection and I am wearing a mask at Tims, at the grocery store and at indoor gatherings.

I reserve the right to modify these recommendations as new information arises. Remember, science is not the truth; science discovers the truth. No nasty comments when advice changes. Go with the flow.

Most importantly, be optimistic and don't read too much or watch too many news programs. The press may make things seem worse than the are. Re-read the paragraph where I mention the miracles of science and medicine. We are learning to live well with COVID-19. We just need to be smart about it.

Anne-Marie

Please share.

As we continue to work to help vaccinate the beautiful people of Lesotho, consider donating on behalf of your mom. You can click to donate here:
https://www.braceletofhope.ca/ways-to-give/
For non-Facebook users, you can find this post here:
https://braceletofhope.blogspot.com/
For mental health support here:
https://familyserviceguelph.on.ca/
For local assistance with anxiety and depression:
www.here4help.ca
CMHA WW Website: www.cmhaww.ca
Here 24/7 at 1-844-HERE-247 or www.here247.ca.
And for post-secondary students, Good2Talk
https://good2talk.ca/

Post COVID-19 infection.....TIMES TWO

 

I woke up this morning and felt like myself for the first time in 2 and a half years. I realized that moments of feeling contented, grateful and hopeful have become rare. I felt one of those moments last night. It's not even a moment really, more like a brief ray of passing light. It's funny, these brief moments. They remind me of how I used to be and how I used to feel most of the time and they come during the most mundane activities: brushing my teeth, cutting a tomato, making my morning coffee. And this one most frequently brings me that fleeting of joy; pulling out a fresh pair of pyjamas.

Yeah sure, let's talk about pyjamas in a facebook post. That should stir things up. I keep my PJ's in two neat stacks. One stack of bottoms and one stack of tops. My closets and drawers are in a state of mayhem but not the shelf my PJ's are on. When I see that shelf, that sense of peace washes over me ever so briefly as I pull from both piles. It is so bizarre. I have thought about this a lot because, frankly, I'd like this feeling to be present more often, as it used to be. It's the end of the day. I have PJ's to get into. I have a nice comfortable bed in a comfortable home in a safe place. The day's stress is over and now I can allow my burned out brain and body to rest.

Yes. PJ's and all the evening trappings.... gifts that many people in the world do not have.

I am grateful.

So, where did COVID- 19 go and where are all the updates? It would seem that it is not politically correct to update you about this pandemic anymore. It also seems politically incorrect to make efforts to restore your health care system and support your healthcare staff; thus the burn out. Google seventh wave of COVID and you won't find much. But here it is. We are at the start of a seventh wave driven by two Omicron variants: BA-4 and BA- 5. In the middle of June BA-5, the variant that is causing the most concern of the two, made up 14.8 % of all cases in Ontario with a weekly growth rate of 3.1 %. It now makes up 70 % of new cases in Ontario.

https://www.publichealthontario.ca/-/media/Documents/nCoV/voc/2022/06/evidence-brief-ba4-ba5-risk-assessment-jul-8.pdf?sc_lang=en

It is more transmissible than the original Omicron variant but it seems to cause the same amount of morbidity and mortality with most people suffering mild to moderate illness and a small percentage requiring hospital admissions.

Test positivity is up to over 13 % and waste water signals are climbing. There are about 1100 new cases/day and the number of people requiring hospitalization due to COVID is up to 741 with a weekly increase of about 136.

https://covid19-sciencetable.ca/ontario-dashboard/

The number of people in the ICU is also increasing. Welcome to the 7th wave. So, what are we doing about this? Pretty much nothing as far as I can see. What should we do about this? Update your vaccines and wear a mask in indoor crowded settings. That includes stores, restaurants ( before you are seated) churches and indoor recreational events and gatherings. You don't have to wear a mask if you are not inclined but let me tell you my own story. The first week of May my husband brought Omicron home from his hockey team's change room. He passed it on to me. I still love him. At that point in time, we were likely infected with the original Omicron variant. He was quite unwell. I missed a day of work, suffered through a four day weekend with very mild symptoms and was fully recovered. Then, I went to San Francisco to visit my son and his partner. This was the last week of May. I took off my mask to eat and drink on the plane home and that was a mistake. BA-5 is most likely what hit me and it hit me hard and fast. I was out of commission for 5 days, away from work for 10 and to this day, I have not fully recovered. I feel 10 years older. My energy wanes by mid-day. My brain is not functioning as it used to with new cognitive limits I have never known before. Two weeks ago my office was under-staffed due to illness. I saw 110 patients in four days and it set me back by at least a couple of weeks. If I push too hard, mild symptoms come back. I am only now starting to read again. My garden is not bringing me as much joy and it is a chore to finish 25 km on my bike.

Does it sound like I am complaining? I am not, actually. I am giving a factual account of the hazards of COVID-19 in healthy people over 40. You can definitely get it twice. You can definitely become more ill than you remember ever being before and fatigue, cognitive and mood issues 1 month later happen and they are no joke. I have not posted since mother's day. That's a consequence of COVID.-19 My office is so far behind. Pre-booked appointments are months away. That's a consequence of COVID-19. The emergency rooms and hospitals are filled beyond any reasonable capacity. That's an extremely dangerous consequence of COVID-19. Every aspect of your health care system is struggling. That is decreasing your access to care. That is causing timely treatment to be way beyond any developed country's standard of care. I believe that the average life expectancy will decline as a result And further disintegration in health care is inevitable.

Politically incorrect to update you about COVID? It would seem so. Politically incorrect to put a plan in place to address the annihilation of your health care system? It appears that way to me. Strong words? Maybe. Watch the mass exodus of family and emergency room physicians in the next year and you will think my words were not strong enough.

Here is the name of a new campaign that I hope you will hear more about. " Imagine a world without family physicians (primary care) ". I have worked in countries with no primary care. We should be marching in the streets. Everyone should be protesting in every way possible. We are not because we are totally exhausted.

I am putting myself back in the saddle but it is taking a huge effort to hoist myself up. I will post again. For now, please get a booster dose of a vaccine if you have not yet had one, if only to protect you and your family form having to exist without an intact healthcare system.

If you are over 60 you are eligible for a fourth dose. That list needs to be expanded. I am waiting to see what the fall brings in terms of 4th doses and boosters but no word yet. Here is a link that comprehensively covers third and fourth dose eligibility.

https://covid-19.ontario.ca/getting-covid-19-vaccine

COVID-19 may not be increasing your risk of dying if you are young and healthy but, the extra strain on our beloved health care system is definitely increasing all-cause mortality rates for all of us. Masks back on. Boosters in!

Anne-Marie

Please share.

PS. I am doing just fine. Better everyday.

As we continue to work to help vaccinate the beautiful people of Lesotho, consider donating on behalf of your mom. You can click to donate here:
https://www.braceletofhope.ca/ways-to-give/
For non-Facebook users, you can find this post here:
https://braceletofhope.blogspot.com/
For mental health support here:
https://familyserviceguelph.on.ca/
For local assistance with anxiety and depression:
www.here4help.ca
CMHA WW Website: www.cmhaww.ca
Here 24/7 at 1-844-HERE-247 or www.here247.ca.
And for post-secondary students, Good2Talk
https://good2talk.ca/