Doctor from Ontario science table answers questions on reopening

The Ontario government recently lifted capacity restrictions on some businesses and facilities where proof of COVID-19 vaccination is required, including restaurants and gyms,

The government also intends to lift all pandemic restrictions by March of next year, and capacity limits for businesses that don't require proof of vaccination on Jan. 17.

Though Chief Medical Officer of Health Dr. Kieran Moore said the province is "currently trending toward the best-case scenario" when it comes to COVID-19 and vaccinations, Premier Doug Ford described the plan as a "cautious" one.

The province will continue to closely monitor public health indicators as it lifts restrictions.

Dr. Peter Juni, the scientific director of Ontario's COVID-19 Science Advisory Table, joined Ontario Today on Tuesday to answer questions from callers on COVID-19 and vaccines, as well as share his thoughts on Ontario's approach.

This discussion has been edited for length and clarity.

Q: Tell me about the thoughts that were running through your mind as you heard the latest plan for the future?

I think it's a great plan, as long as we understand what this is about. This is a roadmap: it gives you the earliest time point when restrictions could be lifted, and it basically tells you that's the moment when we look at the data.

And based on the data, acknowledging that we don't have a crystal ball right now and we don't know how this will look in a few months, we will make a decision. 

So I see that as a commitment to have vaccine certificates at least until mid-January, and to have masks at least until end of March. And this is great news — we are doing the right thing, we're on the right track right now. Others are not. Why? Because they actually just made fatal mistakes.

Q. When might Canadians see a third dose of the COVID-19 vaccine, particularly for those over 65? 

When you have an interval that is longer between the first and second dose, what probably happens is your immune system matures a bit. What we tend to see quite consistently is if this interval between first and second dose is longer, then the extent of protection against any infection is just a bit longer lasting.

This will help us to keep the effectiveness a bit higher. But if you're above 65 or so, there will be a moment when the third dose will be around the corner. 

Q: In my work in public health, people are still asking, "Why get vaccinated if you can still get COVID and transmit COVID?" Why don't you address that?

Oh dear. Okay so this is all about probabilities here. If you get vaccinated, your risk to actually get COVID is reduced by 85 per cent. That's a sevenfold reduction in the risk. And even if you have a breakthrough infection, you will be about half as likely to transmit it to others. 

Talking about being admitted to the hospital or the ICU, the reduction in the risk is 95 per cent, roughly. So when you look at that, it's an absolute no-brainer. Of course you need to get vaccinated, [but] no vaccine is perfect. As with everything else, even if you wear a seat belt in the car you could still actually have an accident and you could still get hurt. But the belt in the car reduces your risk massively. It's the same for the vaccines.

Q. What's your opinion on working in an environment without masks or distancing where the employers all claim to be double-vaxxed?

That's a no-go. I had somebody writing to me the other day [about this]. It's a misconception here. This thing transmits through the air, and the vaccine is great but it doesn't protect 100 per cent. So what do we need to do? Forget about Plexiglas, forget about not doing anything. What you need to do is great ventilation — everybody is vaxxed, great — but in addition what you would need to do is just wear a mask, and it would be great if there was a little bit of distance between the people ... 1.5 (metres) or so. 

But the most important parts are [being] fully vaxxed, great ventilation and continue to mask. I'm sorry, we need to do [masking] a little bit longer.

Q. How much longer? So the government is saying March...

It may well be. Look, the point is that if we don't fall into the trap of a new variant — a super mutated Delta that escapes the immune system fully — then I believe March, April is indeed what we're talking about here. Why? Because we'll have good weather again, the good weather will help us tremendously. 

Remember what I've kept preaching for months now, nearly a year: outdoors is about 20 times safer than indoors, perhaps even more. So once we move outdoors again and enjoy ourselves at the beach etc., all will be fine anyway, together with the vaccines and the third-dose strategy.

And the point is we just need to make it until there, and we need to move just into the next phase of this thing — leaving the pandemic phase, and go into something where we don't have big waves anymore, just small ripples. 

And this means that those people who are not vaccinated will need to get infected over time in a way that we don't see our ICUs [being] overwhelmed.

Q. Should you go into a restaurant after Jan. 17 if they do lift vaccine passports?

That's exactly what I did in Oxford, [England]. Nobody had vaccine certificates there, I really didn't feel safe.

I believe we really need to look at the numbers and how it looks, but right now I'm very reluctant to go into a restaurant indoors anyway already. If no vaccine certificates were there, I would not necessarily go.