Ask the Pharmacist

Q) What is new with COVID and our response to it?

A) Well, as anyone who ventured out on Monday the 21st probably discovered if they had not been paying attention to the news, the days of mandatory masking have come to an end. This will undoubtedly make for an awkward adjustment for many of us who have gotten so used to the “new norms” of the last two years.

At this point in time, the province will stop enforcing masking rules in most indoor settings including schools, restaurants, gyms and most other public spaces. Business owners will, and should, have the right to choose whether or not they will require masking within their premises. It is our fervent hope that the public will respect their right to make this choice and grant them the respect and tolerance we all deserve.

While many of us are tired of donning masks all day and looking forward to a time when hopefully they will be just a memory, it is important to remember that the pandemic is still going on and there are still many of us who are at a high risk from an infection or may live with a loved one with a compromised immune system. Their choice to protect their health or that of others is a decision we should respect, not ridicule.

Wearing a mask is not a major hardship for 99% of us so hopefully the businesses that do maintain a masking rule will not be punished for their understandable decisions. We should also respect the decision of those who no longer wish to wear a mask. All of us have assumed that at some point in time life would return to the way we remembered it. While there are undoubtedly some out there who are nervous about being around others who are maskless, the experts who advise our elected officials feel that now is the time to take our first tentative steps back into our normal cultural habits.

Do not judge those who are done with masking harshly. They are not breaking any rules and we need to cross this threshold at some point.

There are, of course, still some places that will continue to require masking under Ontario’s current laws. These include health care settings such as hospitals and medical clinics, long-term care and retirement homes, shelters, jails, congregate care and living settings and public transit.

Interestingly, pharmacies fall between the cracks when it comes to the new rules. While we are obviously a health care setting, we are not specifically referenced in the new rules so there is uncertainty at this moment as to whether the decision to enforce mask wearing by our patients will be up to the individual owner. Undoubtedly, the number of infections will rise as we start to co-mingle without masks. This does not make it a poor decision on the part of our government and their health policy advisors.

Currently, COVID cases have been trending down. Last week had declined to 615 in Ontario as of Friday and our provincial ICU occupancy dipped below 200 on Thursday for the first time all year. A moderate increase in COVID-19 spread, based upon more maskless encounters, is not expected to increase hospitalizations to more than 1,000 which should be easily handled by our healthcare system.

In other COVID news, it is now assumed that the BA-2 strain of the virus will be the dominant one by the end of this month. This new strain has gained the nickname “stealth” Omicron. It gained this nickname due to its ability to evade detection by PCR testing, a problem since rectified, and it is highly contagious. Strangely enough, while we talk about it as being new, it really isn’t when you consider how quickly strains of this virus go through a typical life cycle.

When scientists first detected Omicron back in November, they realized that this variant had three genetically distinct varieties. Initially BA.1 was 1000 times more common and drove the tremendous spike in cases we saw this winter. BA.2 seems to be catching up due to its unique mutations which make it more transmissible than the BA.1 version. A study in Denmark demonstrated that BA.2 is substantially more likely to infect housemates than BA.1 and that it also takes less time for BA.2 to infect another person, both of which should accelerate its spread throughout our communities.

Despite this, there are a number of reasons to doubt that it will drive a large new spike of cases and hospitalizations. This is mainly due to our high vaccination rate and our introduction of booster doses.

Researchers in Qatar have found that booster doses have been about 40% effective against infection with either BA.1 or BA.2 and were about 90% effective in preventing the need for hospitalization. Also proving beneficial is all the immunity that people received from becoming infected with the BA.1 variant. There was some concern that because of their genetic differences that this immunity would not apply to the BA.2 but that does not appear to be the case so there is a residual positive effect left over from the brutal winter we just went through. BA.2 also seems to be as mild a virus as the original Omicron proved to be causing less chance of hospitalization as these versions appear to be less damaging to the lungs than Delta was.

A final positive finding is that a number of our new antiviral drugs seem to be effective against BA.2 for those patients who do wind up becoming severely ill by it. Summing up, it’s never good news when a new variant is discovered, but it does appear that our existing defences should be up to the task despite the fact that society has reopened once again. For more information about this or any other health related questions, contact your pharmacist.