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
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www.here4help.ca
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