Are vaccinated people getting hospitalized with Omicron? Your COVID-19 questions answered
Doctors, epidemiologists answer readers' questions about Omicron, boosters and 5th-wave restrictions
We're answering questions about the pandemic. Send yours to email@example.com — we'll answer as many as we can. We publish a selection of answers online and also put some questions to the experts during The National and on CBC News Network.
Another surge of COVID-19 infections is gripping hospitals, and many Canadians have questions. Are fully vaccinated people getting hospitalized with Omicron? When will restrictions be lifted?
We spoke to doctors and epidemiologists to get some answers.
Are vaccinated people getting hospitalized with Omicron?
Yes, some people who have received two doses are being hospitalized with COVID-19, including Omicron, but that doesn't mean the vaccines don't offer protection against severe illness.
Dr. Isaac Bogoch, an infectious diseases specialist at Toronto General Hospital, explained this in an interview on CBC News Network in late December.
Omicron does chip away at some of the immunity provided by vaccines, he said, but two doses does "a lot of heavy lifting" in keeping people out of hospitals and intensive care units (ICUs).
More research is needed to know exactly how protective booster doses are against severe outcomes with Omicron.
National data shows that as of Dec. 18, 2021, before the height of the Omicron wave, about 80 per cent of people hospitalized and 76 per cent of people who died with COVID-19 were unvaccinated.
When looking at the number of hospitalizations by vaccination status, it's important to remember that the number of vaccinated people in Canada is many times higher than the number of unvaccinated people.
This graphic illustrates why only looking at the raw numbers of vaccinated and unvaccinated hospitalized COVID-19 patients might be misleading:
Bogoch said rising number of hospitalizations is the "sad reality of when you start to see … very, very high case numbers." He said that a "small percentage of a massive number of people infected" ends up being a lot of people who need medical attention.
When will restrictions be lifted?
One reader wrote in to ask CBC what percentage of the population needs booster shots in order for restrictions to be lifted. But the two aren't necessarily related.
The percentage of people who get booster shots is not a good measure of when restrictions will end, Dr. Nelson Lee, interim director of the University of Toronto's Institute for Pandemics, said in an email to CBC News.
That's because it takes a week or two for the shot's effect to kick in, Lee said, and because the vaccines' effectiveness against infection with Omicron is "less than ideal."
Dr. Gigi Gronvall, an immunologist with Johns Hopkins University, agreed that boosters aren't a golden ticket out of the Omicron wave.
"I don't think that boosting itself will end the pandemic, but it will reduce the consequences," she said in an interview.
Lee suggested looking at hospitalization numbers for a sense of when it will be safe for restrictions to be lifted. Last year when Ontario reopened gyms and lifted capacity restrictions on restaurants and retail stores, there were 202 patients in ICUs with COVID-19-related illness.
Are Canadian provinces unique in limiting testing for COVID-19?
Ontario and Quebec aren't the only jurisdictions limiting access to PCR tests. Israel has earmarked PCR tests for people who are over 60 or have weakened immune systems, and other Israelis have to rely on rapid tests. England has also asked people who test positive on rapid tests to self-isolate instead of seeking PCR tests for confirmation.
Omicron has changed the reality, Gronvall said, and some experts now believe governments should only keep detailed accounts of how many people have COVID-19 in certain settings, such as nursing homes, and just make estimates for the rest of the population.
That may happen, "regardless of whether people think it's a good idea or not," Gronvall said, "just because of the pace of infections and clear inability of testing to keep up with it."
The new variant has been a challenge everywhere, Gronvall said. She said even countries that she previously celebrated for having strong testing strategies, like the United Kingdom, are now struggling to keep up.
Is there any point to vaccine passports since it's possible to catch Omicron even if you're fully vaccinated?
"I think it depends on what provinces and territories think the point of a vaccine passport is," said Dr. Anthony Fong, an assistant professor of emergency medicine at the University of British Columbia. "Is it to make businesses safer and prevent disease transmission between clients and customers? If it is, then likely requiring vaccination … will continue to make sense."
The definition of fully vaccinated will have to be reconsidered now that Omicron is here, Lee said. It would be reasonable to require a third dose for vaccine passports, he said, noting that the unvaccinated are still at the highest risk of the most severe infections.
Quebec has already said it will require three doses for its vaccine passport system.
How can you prove your COVID status to an employer without a test?
"This is a really difficult question for the employee," Fong said. "And I would approach this question by putting the onus really more on the employers to not require proof of positive tests."
He said that even in provinces that haven't limited eligibility for PCR tests, like B.C., the tests are becoming harder to access.
"And as the burden of disease in the population goes up, it becomes more and more likely that everyone who has symptoms probably has COVID-19."
Employers need to accept an employee's self-reported symptoms as proof they need to stay home, he said.
"Take it at face value. It's in the public's best interest for them to isolate at home."