We can never let down our guard

“With 21% of residents now fully vaccinated as Team Ontario sets new records in daily shots, we can be confident that the worst of the pandemic is behind us.” –Ontario Premier Doug Ford Can he really be so certain? In much of Canada, the COVID-19 pandemic seems to be on the wane. New case counts are down 90% since mid-April and are comparable to those last September. The seven-day average for new deaths from the virus dropped 61%. In Ontario, 75.8% of adults have received at least one dose of vaccine and 22.4% are fully vaccinated. Ontario has cancelled border controls with Quebec and Manitoba. Alberta plans to lift all restrictions on July 1 and will hold the Calgary Stampede. Several other provinces have announced reopening plans. Yet we can never let down our guard. As Dr. Theresa Tam noted, cases of the delta (Indian) variant increased 66% in a three-day period. She warned, “If the variant takes hold and we don’t have high enough vaccine coverage, what you will see is probably a resurgence in the fall period.” For most of the pandemic, Nova Scotia had been in the “Atlantic Bubble” and had restricted visitors from other parts of Canada; it also received no direct international flights. However, by mid-May, there was a peak of 227 new cases per day. In early May, Manitoba had few cases compared to Alberta and Ontario. Several weeks later, it became the epicenter of North America. In early June, Yukon had no active cases; in Whitehorse, 80% of persons had received the first dose of vaccine and 72% the second. Yet only 10 days later, an outbreak of 21 cases was reported—largely due to the gamma (Brazilian) variant in unvaccinated persons. By June 22, there were 100 active cases. Kashechewan First Nation, a James Bay community of 1,800 residents, managed to vaccinate most of its adults, but recently reported 300 cases—half in children. This is largely due to the overcrowded housing, lack of isolation centres and the fact that children could not be vaccinated. Unexpected surges have also occurred in Vietnam, Taiwan, and Singapore. Much of this is due to the delta or Indian variant, which is 50% more transmissible, causes double the rate of hospitalization, and is more resistant to vaccines with only 30% to 40% protection after one dose. It already accounts for over half of new cases in Ontario, with ten “hot spots.” After a slow start, about 75% of Canadians age 12 and over have received at least one vaccine dose—the highest in the world. Except in the territories, only 20% of eligible persons have been fully vaccinated and an Ipsos poll found that nearly 20% are hesitant or refuse to get the vaccine. The premiers cannot rely entirely on vaccines; they must use all the potential tools in their toolboxes. This requires increased rapid testing and contact tracing, adequate paid sick benefits, increased numbers of isolation centres and greatly enhanced temporary funding from Ottawa. If indeed there is significant airborne transmission of the coronavirus, as Dr. Joe Vipond et al assert (Toronto Star, June 21, 2021), then possibly there should be greater use of N95 masks in hospitals and high-risk workplaces. Prior to the pandemic, Quebec mandated two paid sick days per year and Prince Edward Island one day. Ontario used to require two days, but this was repealed by Doug Ford in 2018. As I outlined in my previous article (May 17, 2021), New Brunswick and Newfoundland and Labrador still provide no paid sick leave. P.E.I. has a temporary fund which reimburses up to $160 per day for six days for vaccination, for testing, or self-isolation. Quebec provides paid family leave with a financial benefit of $575 per week to workers forced to isolate because they have COVID-19 or have been in contact with a positive case. Yukon has the most generous plan, and pays $378 daily up to ten days. For many months, Ford and Jason Kenney blamed the problems on a poor supply of vaccines and lax border controls. However, they largely ignored workplace infections and inadequate paid sick leave. Ford relied on the federal Canada Recovery Sickness Benefit. However, the CRSB pays only $450 per week after taxes (less than minimum wage), persons must apply every week, it does not cover shorter leave times, and remittance may take several weeks. As the CRSB was not improved in the federal budget, Ontario provided three paid sick days; businesses would pay up to $200 daily, and be reimbursed by the WSIB. This program expires in September. In the past week, the number of claims doubled, but sick days were mainly taken for “vaccine-related issues” and Deena Ladd of the Workers Action Centre termed the overall number of claims still “miniscule.” Manitoba brought in a program that would provide employers with up to $600 per employee for up to five days. British Columbia Premier John Horgan admitted that, "Unfortunately, the federal program has been difficult to access for workers.” B.C. then agreed to pay employers up to $200 per day for three days and Nova Scotia one to pay up to $160 per day for four days. Alberta will cover three hours of paid leave when persons are vaccinated, and self-isolation support with a payment of $625, for a total of $2000. However, in all provinces, sick employees, when needing 10-14 days off, would also have to apply for the federal CRSB, with all its defects. Across Canada, there is a patchwork of inadequate, overly-complicated plans; this deters ill workers from staying at home. There is no seamless, easy way to obtain sick benefits without incurring an interruption or loss of income. Alberta NDP leader Rachel Notley has proposed ten days of paid sick leave. Isolating workers would continue to be paid through their employer, who would be reimbursed by the province, which would be ultimately paid by Ottawa. Ford and the other premiers should mandate sufficient paid sick leave for all workers. New Brunswick Premier Blaine Higgs has always tried to restrain public spending, but in this urgent situation, he should agree that Ottawa should provide more generous funding. As a chartered financial accountant, Manitoba Premier Brian Pallister should realize that all governments should better collaborate; so should Quebec Premier Francois Legault with his degree in business administration. Moreover, Legault’s mother was a grocery cashier, and he can hopefully empathize with high-risk essential workers who still lack adequate sick benefits. Ottawa should immediately agree to reimburse provinces and territories for funding businesses and the self-employed for this leave. It should also pay provinces and territories to provide adequate sick benefits to MDs, nurses, and all health professionals. Many have still not received their second vaccine dose. Even if many premiers are willing to overhaul the national pandemic sick benefit program, they need increases federal financial assistance. Sadly, this seems to be a low priority for Justin Trudeau. Whereas the US Congress is only off during August, the last day of our Parliament is June 23. An election is likely in the fall. Will this issue simply “fall off the radar”? With the delta variant in one territory and every province, and soon to become the predominant strain in several, we need as many Canadians as possible to be fully vaccinated. Yet at present, 80% are not, and nearly 20% are reluctant to do so. In overcrowded “hot zones” children are victims and also vectors of the virus, but currently are not eligible for any vaccines. We all need leadership, better coordination, and the immediate promise of sufficient funding by Ottawa now, and cannot wait until a new session of Parliament resumes after the election. Indeed, we should never let down our guard if we are to avoid a fourth wave of this pandemic. As Dr. Catherine Elliott, Yukon chief medical officer of health warned, “If we let out guard down, COVID-19 is highly transmissible and will spread.” Ottawa physician Dr. Charles S. Shaver was born in Montreal. He is past-chair of the section on general internal medicine of the Ontario Medical Association.

We can never let down our guard

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