2022-04-05/06 BC

The province announced that they are going to switch to only reporting numbers once a week, and implied that it would be Thursdays. They also implied that the data would be a week old at this point.

In conjunction with this, I think I am going to switch to once-per-week reporting, probably on Thursdays.

Today I pulled some of the actionable information from the press briefing into separate, headlined sections because, well, they are actionable and the briefing section is long. If I don’t cite the source, it’s from the press briefing.

Testing

I think this is worth calling out separately. In the press briefing, they said that any adult will be able to go to pharmacies and pick up RATs after April 11, and you don’t need to show a CareCard. I have a horrible feeling that this will lead to a dramatic tragedy of the commons. (I wish reporters would ask questions about things like this instead of AGAIN asking, “what do you say to immunocompromised people who you have left in the lurch?!?!?!”)

What’s to stop people from picking up 50 boxes? Even if they can’t do it at Pharmacy A, what’s to stop them from going to 50 pharmacies? What’s to stop Americans from coming over the border and snagging boxes paid for with Canadian taxes?

Vaccines

The province announced that it would be allowing second boosters for:

  • Anybody over 70.
  • Indigenous people over 50.
  • Anybody in a Long-Term Care or Assisted Living Home.
  • Anybody on the Clinically Extremely Vulnerable list. (Note that a second booster would be a 5th shot for the CEVs.)

Novavax is in Canada! It should be in BC late this week or early next week. If you are one of the several thousand who signed up to get a Novavax shot, the province says you’ll be getting invites very soon.

Press Briefing

Here is the video.

They told people to get boosted every chance you could. When you read this, just imagine every period is actually a period plus GO GET YOUR BOOSTERS, EVERYONE BUT ESPECIALLY THE 68K OF YOU OVER 70 WHO HAVEN’T!


Dr. Henry spent a lot of soothing words and pictures on reassuring people that we were in a good place and could afford to lift more mitigation measures.

She threw up a number of graphs which she said showed cases levelling off. Occasionally she would admit that there was a slight uptick recently.


She talked about how we have great immunization rates and how the vax are still giving us good protection.

The following chart is a little difficult to interpret: the important thing is not the purple or red bars — those are the case numbers for Fraser Health and VCH — but the tall black boxes: those are the points when they rolled up serosurvey data. The graph is hard to read (apologies, these are screengrabs from the video because they didn’t post the slides, grrrrr), but the most recent serosurvey — after the big Omicron peak — says that >85% of people are vaccinated and >90% have immunity acquired either from infection or vaccination.

Dr. Henry made a big deal about there being 90% of the population with some level protection now, and that was different from any other wave. (It was only 75% in that mid-Delta point on the graph above.)

While yeah, it’s nice that 90% have some level of protection, the UK had really high levels of protection, and BA.2 still hammered it.

I can’t find data now on what percentage of people in the UK had infection and/or vaccination, they have had high vax rates among their adults, and they got massively hammered by the first Omicron wave. Remember how bad we got hammered? From this web page, the UK had 2.5 times as many confirmed cases per capita as Canada did:

Even so, the UK got hammered by the BA.2 wave and are still getting hammered, with more hospitalizations than the first Omicron wave. From this web page:

Dr. Henry showed a graph of modelling:

This was supposed to be a reassuring graph, but it shows cases rising in May/June to almost as high as Omicron levels in the “20% increase in transmission” case. I do not find that reassuring.

Furthermore, she said something to the effect that we were likely to see a slight increase over the next month to two months, followed by a decline, “if we continue to do the things we’re doing”. I actually gasped and yelled at the screen: “BUT WE ARE STOPPING ALL THE THINGS!” Now, the graph above does have a case where transmission increases by 20%, but

  • that shows cases rising almost as high as the first Omicron wave, and
  • it seems to me that with BA.2 being 1.5x as transmissible as BA.1 and dropping a bunch of restrictions, it’s not at all unreasonable to think that transmission might rise by at least 50%.

So, despite all of Dr. Henry’s soothing words and her dropping restrictions, I am not at all convinced that BA.2 won’t hammer BC.


The changes to mitigation measures, effective Friday morning at midnight-oh-one, are:

  • Use of vax card is no longer required anywhere. (At their discretion, businesses can decide that they want to use the vax card or require masks for their customers and/or employees.)
  • College/university vaccination mandate is lifted.
  • Businesses will change from needing a COVID-19 Safety Plan to needing a communicable disease plan. I have NO idea what the difference is.

Dr. Henry announced that they would be making changes to reporting. Some I mentioned at the very top. They are also going to change how they do death reporting, moving to reporting all-cause mortality of anyone who died within 30 days of getting a positive COVID-19 test. She said something that I did not understand: that they would be overcounting at first, because it would take a few days to get the linkages between lab tests and vital statistics, but that as they get death data from vital statistics. The only thing that I can figure is that they will issue preliminary stats for 30 days since positive test, but they will go back afterwards and change it to people who had COVID-19 listed on the death certificate.


On regulated health professionals, I think the upshot is that while all of health care professionals who are employed by the province still have to get vaccinated, the others (chiropractors, dentists, massage therapists, etc.) won’t have to get vaccinated, but their vax status does have to be made available to clients somehow. I’m not sure how that is going to work. (I wish reporters would ask about things like this…)


DrH talked briefly about other surveillance streams:

  • Sentinel surveillance, like they currently do for influenza. I believe this is sampling from doctor’s offices, basically. Flu surveillance has a long history, I am satisfied that it works well.
  • Monitoring in LTCH and hospitals.
  • Wastewater monitoring. She mentioned that they are going to expand wastewater monitoring, both to have a wider geographic reach and also to monitor more/different pathogens. I think this could be awesome.
  • “Monitoring of healthcare visits” — I don’t know what that is.
  • Targeted serosurveillance — I don’t know what the targeting criteria are.
  • Genetic sequencing.

The province has received 50M RATs

  • about 40M have been deployed,
    • of which ~9M have been distributed to pharmacies;
      • of which about 4.3M have been picked up by the public
  • 0.5M are not appropriate for home use
  • they have an inventory of about 9M.

There were ZERO surgical postponements last week, the first week since September that’s happened. Dix was really happy about that. I think he should enjoy it while it lasts.


I think Dix said that rapid tests would still be distributed via schools.

Q&A

Reminder: I grumpily and snarkily paraphrase. If you wonder if they really said that? No, of course they didn’t, that was me.

Q: Some businesses might want to keep vax card, which ones? A: [Vague answer suggesting maybe some restaurants, small shops, theatres, and museums, but really that’s up to the business]

Q: What are recommendations for businesses who put in vax req for employees, should they keep doing so? A: [rambling answer that I think worked out to “that’s up to the business possibly in conjunction with their labour unions”]

Q: When are we going to see changes to how many visitors LTCH residents can have? A: Um, we already lifted the limits. As many vaccinated visitors can visit as you want. There’s still rapid tests for visitors, but we’re looking at how we can cut that down, especially for people who go regularly. If you visit every day, maybe you only need a RAT twice a week or so. And maybe now with RATs being easily available, maybe you can take your RAT at home instead of onsite.

Q: Was it premature to lift the mask mandate? A: We changed the legal requirement to wear masks at all times in indoor public spaces, but we still encourage wearing masks in dangerous situations. We think we’re at a place where that’s okay.

Q: People are being slow about getting third doses, what makes you think they will go get fourth doses? A: DrH Oh, they will. Old folks be scared. Dix: Of people over 70, like 95% have gotten their first dose, 92% their second dose (so 97% of people who got #1 got #2), and 90% have gotten a third dose. So I’m offended that you say it’s been slow, our booster program has been fucking awesome.

Q: How many people have had the virus? A: It varies across age groups, but probably about 50%. Remember though, that most of those were vaccinated (because almost everybody is vaccinated). Fortunately, because they were vaccinated, their symptoms were not as severe, because COVID can cause heart inflammation which can cause strokes and heart attacks, which can have lasting effects. Fortunately Omicron has less of that, yay. <- Note, I do not think DrH was talking about Long COVID here.

Q: Ya gonna offer boosters to the general population? A: At this point, our data says it is not needed, but we don’t know what is going to happen in the future. There are certainly scenarios where another shot would be needed.

Q: Will RATs pick up BA.2? A: If you use the tests when you are symptomatic, it should pick it up as well as BA.1. But there are a lot of false negatives, so if you still feel crummy, take another test the next day.

Q: Data’s going to come out once a week, please tell me that you will have access to more frequent data. A: Pfft, yeah, of course. We look at so many numbers every day, even data on stuff we haven’t ever shared with you. SO MANY NUMBERS!

Q: Uh, that modelling graph, uh, it’s like totally scary. With a 20% increase in transmission, it shows cases almost as high as the first Omicron wave. Am I misreading it completely, or are we fucked??? A: It’s a model not a forecast, but yeah, we expect some more cases, but don’t worry, it won’t translate into as many hospitalizations, and it will be a slow rise, not a fast rise like Omicron, so we’ll be able to manage it. [More soothing words, said with confidence]

Q: You said that we were still seeing a low rate of death, but wtf, a third of the COVID-19 deaths happened during Omicron. Why are we dropping protective measures now, and what do you say to the immunocompromised? A: [soothing words] Balance. We always have had as one of our goals to minimize societal disruption. We’ve always wanted to do the minimum needed. And yeah, there’s no time when there’s no risk, but there wasn’t in Before Times, either. [Editorial: She has a point here: immunocompromised people have always had to worry about colds etc.] Dix: we have always put the most vulnerable at the top of the list, which is why they got vax first and got RATs first. Now, there are antivirals that we are giving priority access to the most vulnerable.

Q: With data only being dropped once a week, how will we know if shit’s going down? A: COVID is like the climate, not the weather. The stats just don’t change that fast. Dix, in French translation which did not make it into English: And if it is changing that fast, we’ll tell you.

Q: When are we going to be done with this shit? A: Fuck if I know. I’m hoping that the summer, with the warmer weather, will be better, but I expect that when we move into next fall’s respiratory season we’ll have at least a little bit of a resurgence. But maybe we’ll need an annual booster, I don’t know. [Editorial: she frequently characterizes COVID-19 as a seasonal virus, and from what I have seen and read, yes, there is some temperature/humidity effect, but it is absolutely dwarfed by A) the effect of new variants and B) human behaviour.]

Statistics

  • Mon/Tues: +258 cases, +2,748 doses. 334 in hospital / 35 in ICU, +2,748 doses.
  • Tues/Wed: +216 caes, who knows how many deaths. Currently 329 in hospital / 37 in ICU, +3,014 doses.
first dosessecond dosesthird doses
of adults93.8%91.5%59.5%
of over-12s93.5%91.1%57.8%
of over-5s90.9%87.5%*
of all BCians>90.0%>86.5%>53.4%

Charts