Dr. Hinshaw tells CBC News there has been a 'dramatic shift' in COVID-19 risk to the general population

The dramatic shift in the risk the coronavirus poses to the general population justifies removing Alberta's remaining COVID-19 protocols, the province's chief medical officer of health, Deena Hinshaw, told CBC News.

Removing public health protocols part of preparing for other diseases this fall, she says

Dr. Deena Hinshaw, Alberta's chief medical officer of health, at a news conference in November 2020. She spoke Thursday on CBC's The Homestretch about the government's new approach to COVID-19. (Government of Alberta)

The dramatic shift in the risk the coronavirus poses to the general population justifies removing Alberta's remaining COVID-19 protocols, the province's chief medical officer of health, Deena Hinshaw, told CBC News.

Alberta announced Wednesday that it will soon have no mandatory COVID-19 protocols: no more mandatory masking, contact tracing or isolating. It's part of a move to treat the coronavirus more like other respiratory viruses.

Starting Thursday, anyone with COVID-19 symptoms or a positive test result must isolate, but quarantine for their close contacts will be recommended and not mandatory. 

On Aug. 16, isolation following a positive test will no longer be required but "strongly recommended," and by the end of August, testing will be scaled back to only those with severe symptoms.

Calgary Mayor Naheed Nenshi said that lifting the remaining health orders in Alberta was "the height of insanity."

Hinshaw spoke to Jim Brown on The Homestretch on Thursday about the decision.

The following transcript of the interview has been edited for clarity and length.

Q: Alberta has one of the highest rates of unvaccinated people in the country, the lowest rate of first doses administered and one of the highest daily rates of new COVID-19 infections over the past seven days. Why is Alberta taking the lead in treating COVID-19 like other respiratory viruses?

A: There's going to be a large number of other respiratory viruses that we're going to have to respond to this fall. We know that influenza and RSV [respiratory syncytial virus] will be coming back, two viruses that cause a lot of illness in our population, and we need to get our system ready.

We knew that we wouldn't be able to continue to test everyone with just a mild illness because there's going to be so many more viruses out there. We also know that the vaccines we have are highly effective and that they really shift the risk that COVID-19 brings to our population in general.

From an individual perspective, there's still definitely a risk of COVID-19, particularly for those who aren't vaccinated. It's critical that everyone who hasn't yet accessed that protection really look very carefully at the data, use reliable sources for information and really consider getting that protection as soon as possible.

Q: What about not notifying close contacts?

A: When we're looking at the risk that COVID-19 poses to the population, there's been a dramatic shift in the last few months as we've had the great opportunity of large quantities of highly effective vaccine available.

Another component of getting ready for the fall is looking at the appropriateness of extreme interventions and how we weigh the risk of COVID-19 with high vaccine levels against the risk of other types of public health issues. Those kinds of widespread interventions become less proportional to the risk as our vaccine coverage goes up. 

Q: There's a lot we don't know yet, particularly with the delta variant, about breakthrough infections and the virus load that vaccinated people can carry. Why don't we wait until we know more, since delta is driving most of our cases right now? 

A: We absolutely need to be continuing to watch the delta variant. But we know from our own Alberta experience that vaccines with two doses are highly protective against the delta variant with respect to infection and even more protective when it comes to severe outcomes.

Of all the cases we've had since July 1, when the delta variant has been dominant, 95 per cent of those are in those who are not fully vaccinated. The No. 1 thing that we need to be doing is to be encouraging people to access the protection that vaccine offers.

Q: There are other jurisdictions reimposing mask mandates to deal with the spike in delta cases — even Disney World and Disneyland. To paraphrase a local political scientist yesterday, why does Disney World care more about my children than my provincial government does?

A: It's important to remember that COVID-19 is not the only risk our kids face. For children under 12 in particular, COVID-19 infection is equivalent to or even possibly slightly less risky than something like seasonal influenza.

If we look at our last seasonal influenza year of 2019-2020, we had a higher ICU rate for influenza in kids between the ages of five and nine than we've had for COVID-19 throughout the last 17 months.

Q: The reason 2019-2020 was our last seasonal influenza season was because of all of the measures we were taking last year for COVID-19. 

A: Seasonal influenza, which we've dealt with with our kids every year since they were born, is something that we know how to navigate. And that's the kind of level of risk that COVID-19 poses to those young children.

We have a highly vaccinated population and as we've been able to offer that protection to people, it changes the overall population risk in a way that allows us to refocus not just on COVID-19 as the major risk for our communities, but as one of many risks.

Q: We have climbing cases right now and seem about to enter a fourth wave. With assessment centres closing at the end of August, how will we know the rate of spread of COVID-19 in this province?

A: It's important that we continue to monitor COVID-19. We will be expanding our wastewater surveillance program. That can help us at a geographical level to know where COVID-19 is spreading.

We are using the Sentinel Surveillance Network of primary care physicians to understand the community impact of COVID-19 for those who are presenting to their physician's offices.

We'll be monitoring spread and outbreaks and there will be testing for those who need care. If they're sick enough to require emergency care, we'll be monitoring those results as well.

What's critical about the shift in how we're approaching COVID-19 is that individual cases are not as important when we have high vaccine coverage. Vaccines provide a very effective layer of protection, particularly against severe outcomes.

Q: If the data shows this was a bad decision, are you open to acknowledging that an error was made and reconsidering these policies? 

A: We will absolutely be monitoring and particularly monitoring the severe outcomes related to COVID-19. We are going to be using all of the available public health tools that we continue to have to respond if we see local surges that are starting to have an impact on severe cases.

What we're doing is we're moving away from a universal provincial approach to COVID-19 that we needed to use before we had widely available vaccines. What we're moving towards is an approach that monitors and intervenes at a local level, as we do with many other diseases.That is the plan, to make sure that our interventions are targeted and focused on areas where we do see problems emerging.

Q: What would you say to people who are deeply concerned and embarrassed by yesterday's announcement?

A: I think it's understandable that all of us have been in a pandemic mode for 17 months. We've been approaching COVID in a particular way. The speed with which we've been able to roll out vaccines in the last few months and the way that that has changed the risk profile has happened very quickly. There are obviously diverse opinions about different courses of actions.

We're moving through this next phase into how we live with COVID-19 the same way that we moved through other phases. We're moving into new territory together, into things that we haven't previously experienced.

We'll be able to get through this phase by continuing to listen to each other, support each other and focus on the fact that even if we have diverse opinions, the best thing we can do is to be respectful, to listen to each other and to move forward, integrating COVID-19 as one risk among many risks that we need to navigate. 

With files from The Homestretch.

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