Health care worker, wearing a mask and gloves, holding a needle up.
Health care worker, wearing a mask and gloves, holding a needle up. Credit: Nenad Stojkovic / Flickr Credit: Nenad Stojkovic / Flickr

The pandemic has taken an unforeseen turn with the arrival of the Omicron virus.

In short, Canada could run out of people. What does this mean? The Omicron variant is highly contagious. When we are in any public space, someone there is carrying the virus, whether or not they are vaccinated, whether or not they are masked and whether or not they are symptomatic. In other words, COVID-19 is everywhere.

Yes, it is helpful to be fully vaccinated. Emerging research suggests that fully vaccinated people who develop breakthrough infections are much less likely to be hospitalized. If they are, they are fractionally likely to require intensive care intervention, compared to the unvaccinated. Even if they do become seriously ill, there are new treatments available and new medications in the pipeline.

Still, with some one-fifth of the population resisting vaccination, the number of admissions to hospitals is once again threatening to overwhelm acute care facilities. Hospitals simply do not have the capacity to take in the huge influx of cases expected from Omicron. Even hospitals that can still accommodate new patients face a challenge. With so many staff members off because of burnout and their own breakthrough cases, there are not enough staff to care for new admissions.

Hospitals in several jurisdictions have again deferred non-urgent surgery, often for patients who have already waited as long as an extra year for procedures. Their underlying conditions are being left untreated, making their lives more difficult and their health more precarious. It is one arc of a vicious circle.

In the health care system, hospitals are not the only ones being hit with COVID-19, primarily due to Omicron. Other health care workers are also staying home. These include employees in congregate care settings and those who were reallocated to work in vaccination centres. The implications of this compound our ability to increase the number of vaccinated people, both adults and children. At the start of the pandemic, Canada did not have enough vaccines. Now, it does not have enough people to put shots in arms. Another arc of the vicious circle.

Governments, other regulating bodies like public health and some employers have responded to these staffing shortages with different approaches. Some have reduced the number of days of isolation; others have allowed affected but asymptomatic staff to continue working. Because the exact date range of Omicron infection and recovery are not precise, these measures can also contribute to closing the vicious circle.

Increasingly, full vaccination is becoming a requirement for access not only to venues and public spaces, but also to employment. One example: professional sports teams are unable to compete, because so many players and staff are ill. Many employers are reporting that they have barely enough staff available to continue operating.

And then there are unvaccinated people who still do not appreciate the full consequences of their inactions. They want exemptions from being vaccinated, regardless of the regulations that are in place.  Some of these people are more well-known than others. In early January, tennis star Novak Djokovic, the world’s top-ranked male player, was denied entry into Australia, despite his claim to have a medical exemption. Djokovic’s visa was overturned when he landed in Australia. The government insisted that the country’s rule about foreigners requiring full vaccination applies to everyone, no exceptions. A judge ruled that the tennis star could stay, but the immigration minister could still deport Djokovic.

Here in Canada, we are in a strange place. Although some provinces have not announced lock-downs, the extent of restrictions on indoor opportunities and outdoor gatherings has meant a de facto stay-at-home order. In Ontario, for example, many indoor activities are now prohibited. Restaurants and bars are closed for indoor service, theatres and galleries are closed again, as are gyms and pools. Quebec has announced another curfew and also requires vaccine passports to enter government liquor stores and cannabis stores. For those who live in the Ontario portion of the National Capital Region, going to the liquor store may become much more dangerous later in January.

The vicious circle is completing its circumference. Even vaccinated people are not immune from catching COVID-19. This means that neither vaccinations nor recovery from an infection guarantee what is called “sterilizing immunity.” What these measures do offer is significant protection against the most serious illness from breakthrough infections. And this can help decrease the pressure on hospitals.

Like the Omicron variant, the vicious circle bites. Long-haul truckers, both in Canada and the U.S., have until January 15, 2022 to become double-vaccinated. After that date, they will not be permitted to cross the border into Canada, unless they are Canadians who agree to quarantine for 14 days. Unions and trucking groups complain that the timeframe is too short. Perhaps it is, but long-haul truckers have had the same lead-up time to attend to vaccinations as everyone else. Statistics are unavailable, but among drivers in Canada, the unvaccinated rate is at least the same as the general population, which is some 20%.

Imagine the following scenario. Long-haul truckers continue to refuse to be vaccinated. The number of drivers decreases and adds to the already difficult situation in the supply chain. Among other things, produce from the U.S., Mexico and other Central and South American countries does not cross the Canadian border in previous quantities. When it does, food distributors have difficulty shipping the produce to retail outlets, because of staff shortages. Similarly, the retail grocers do not have sufficient staff to either offload the trucks or restock shelves. Customers who do manage to find the produce they want notice price increases. Further, the checkout lines are longer because so many cashiers are home sick.

When families cannot find food at grocers, they turn to restaurants and home delivery options, if they are able to afford it. But these establishments and services, too, have staffing shortages. Further, many restaurants are closing after trying to keep facilities open during the previous 18 months of the pandemic. The vicious circle has completed the loop.

Similar examples could be described for other industries, even those that are considered essential, like health care facilities and pharmacies. Their staff have breakthrough infections like the rest of the population. The same is true at liquor stores. They are showing bare shelves because of supply chain issues. And staff shortages because sickness is on the rise.

In Canada, we are between a rock and a hard place. Remember when we were trying to flatten the curve? With Omicron, we are, one more time. The only thing that can help defeat Omicron — and the Delta variant — is to increase the number of people vaccinated and to continue with masking, hand-washing, social distancing and isolation/quarantine when necessary. This is old news, but it does not make either the rock or the hard place any softer.

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Evelyn Lazare

Evelyn H Lazare is a healthcare planner, strategist and executive. Lazare has led nation-wide healthcare organizations in Canada and has consulted to an array of healthcare and related clients in both...