COVID-19: N.B. top doc says lifting restrictions is safe move now, but expects cases to increase

As the United States and parts of western Canada see a resurgence in COVID-19 cases, officials are asking people to put their masks back on. New Brunswick is set to remove its mask mandate at the mandatory order ends Friday at midnight. As Callum Smith reports, Dr. Jennifer Russell says with very low case counts, no hospitalizations, and rising vaccine rates, public health is comfortable with the risks of the decision.

New Brunswick is set to drop virtually all of its COVID-19 restrictions Friday night, heralding a new and unchartered chapter of this pandemic.

The final phase of the Path to Green reopening plan means masking mandates, gathering limits and social distancing rules will be a thing of the past.

Premier Blaine Higgs’ original plan was to eliminate pandemic restrictions on Aug. 2, — next Monday — but only if 75 per cent of eligible New Brunswickers had received two vaccinations. The premier changed course last Friday, saying low case numbers allowed for lifting of restrictions, even if the 75 per cent target had not been met.

Some infectious disease experts are warning the province should prepare for a surge in cases this fall because of the highly contagious Delta variant.

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While New Brunswick’s COVID-19 case numbers have remained low, the Delta variant is on the move in British Columbia, Alberta and much of the United States. The U.S. Centers for Disease Control recently backtracked and said fully vaccinated Americans should go back to wearing masks in indoor spaces in regions where the virus is spreading rapidly.

The province’s chief medical officer of health, Dr. Jennifer Russell, says she’s comfortable with New Brunswick’s decision based on the current epidemiology.

In an interview with Global’s Callum Smith, she says she does expect case numbers to rise, though, because COVID-19 remains a global pandemic and “the risks will still be there.”

Here’s a look at their chat:

Question: What goes through your mind when you think of the past 17 months and what we’ve endured?

Dr. Jennifer Russell: I think what comes to mind is the extraordinary work that all New Brunswickers have been doing to do their part while we were under such severe restrictions, border measures, travel restrictions, etc., and now stepping up to get vaccinated. I just think of all the hard work that’s been done to get here.

Question: When you think of the fact that there’s going to be no restrictions in place, what does that mean for yourself, personally, and for the province as a whole?

Russell: I think for myself, personally, I mean, we will still have COVID as a global pandemic. So our focus will still have to include ongoing measures in terms of the next phase of the vaccination as well as being able to focus on some non-combat issues that have taken a back seat really to COVID-19 over the last 18 months for the province.

I think, again, the sacrifices of all New Brunswickers are being recognized right now in terms of everybody getting safely to this place for the most part, compared to other jurisdictions. So now we have this opportunity, we have the capacity, we have access for vaccinations for everybody in the province who is eligible. The mobile clinics have been extraordinary in terms of increasing accessibility.

And, certainly, when I see and hear that people are stepping up still for first doses at situations like those clinics, it just means that, again, we’re moving in the right direction. We definitely want to hit our target of 75 per cent with two doses. So we still have some work to do.

Question: Was the decision to expedite that and jump up ahead of the 75 per cent (target) made by yourself and your team, or the government?

Russell: Well, as has been the process throughout the pandemic: the COVID-19 cabinet meets and then cabinet meets and they decide between those two cabinets what decisions will be made.

We provide recommendations to COVID-19 cabinet into cabinet, and then they make those decisions based on their discussions around our recommendations.

Question: What would you say to people in the province who are seeing what’s happening in other parts of the country — specifically out west in Alberta, B.C. — who are worried and are questioning if this is even the right time to go to green?

Russell: I think for people who are vaccinated with two doses, we know that that is going to offer the maximum protection possible against serious outcomes.

Our goal has always been to protect our health-care system. That goal is still the same.

We still will be looking at the numbers of hospitalizations and cases. But the more people that are vaccinated with two doses, we know that each number of cases that hopefully won’t translate into increased numbers of hospitalizations in the same proportion that we saw prior to our vaccine.

Question: An epidemiologist we’ve spoken to says she’s concerned about the under-12 population (who aren’t qualified for vaccination yet) and the fact that we still don’t have any definitive data on when they can be (vaccinated). (Critics say) any province that removes restrictions, it’s moving too quickly. How comfortable are you with this decision at the timing?

Russell: So, first off, it’s really important to get … we’re all waiting for the approval from Health Canada to vaccinate kids under the age of 12 with Pfizer and then hopefully with Moderna.

It would be nice to have that date set and then we can make our plans around that. But we do have our (flu) vaccine campaign coming up. So (we) will continue to be busy around the province immunizing people for flu and with respect to the children under the age of 12 who can’t get vaccinated at this point because, again, we’re waiting for Health Canada approval.

The whole idea of making sure that all eligible people in the province get vaccinated with their two doses, it is so important for the cocooning of that population (under age 12) and to protect them.

So anybody who can get vaccinated should get vaccinated, again, to provide that extra layer of protection for children under the age of 12 who can’t get vaccinated and other people who have immune-compromised medical illnesses.

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Question: But why not wait until those under age 12 are eligible?

Russell: Well, again, New Brunswick has always been focused on the data and the research. And right now, our data in this province for cases and hospitalizations is extremely low.

In our vaccine, rates continue to increase. So it’s always about balancing risks and with public health measures is always important to balance the risk and the mitigation.

And so we can’t justify having a higher level of mitigation than the risk. So right now, the risks are such that we are comfortable moving forward at this time with removing the mandatory order, still with the goal of getting people vaccinated with their two doses and still with the goal of protecting our hospital.

Question: Can you define what powers Public Health will have when there’s no mandatory order in place, what restrictions could be imposed in the future and how necessary do you think that could be?

Russell: So when the mandatory order ends at midnight on July 30, we have examined what Public Health has the capacity to do under the Public Health Act. We’ll also be still working with WorkSafe and there’s an Occupational Health Act as well. And along with all the other public health measures that we’ve been using all along, the Public Health Act would allow us to react to any health hazard and any communicable disease.

We have the ability to write orders that can be enforced by law for individuals and for businesses.

So we will be able to exercise those same powers that we could prior to the pandemic moving forward.

Question: Can elaborate on that? How does that look? What does that mean?

Russell: Well, again, there is the context. When you think of measles and the outbreak of measles, we have the ability to offer vaccines in those situations, we have the ability to order people to stay home and in individual businesses. If there are issues around that, we can’t we can write orders that affect individual businesses.

We have the ability to use measures that we need to on an individual basis, or like a situation with a school or organization to help protect the public. And with respect to our contact tracing, that will continue with respect to our outbreak management, where we’re actually making changes to our outbreak management to reflect vaccinated individuals in terms of the risk. And we are looking into, again, risk stratifying different areas in terms of making public health recommendations.

Just like before a flood. You’ll hear messages from EMO saying, ‘We’re going to have a power outage. Please prepare yourselves for X, Y, Z and do these types of preparations.’

So I can see moving forward that Public Health will be able to give recommendations based on current risks.

And again, right now, our risks are very, very low. But everybody has the choice to follow whatever Public Health measures. Once the mandatory order is lifted, there’s nothing that precludes people to make their own choices about which Public Health measures that existed during the mandatory order, which ones they want to continue as individuals and certainly employers and employees in different organizations.

Question: You say the risks are low right now. What’s your biggest worry, if anything, moving forward?

Russell: Well, again, right right now, we are very focused on getting the population vaccinated — every eligible individual who can get vaccinated. We’re very keen to make that happen. That’s why we’ve increased accessibility. We have so much capacity right now with our clinics, with our pharmacy partners and with pop-up mobile clinics.

It’s really heartening. It’s really positive to see people stepping up for their first doses. You know, I think we’re at 81.7 per cent for first doses. And with each day that goes by, if we can keep edging that up, the likelihood of people who have gotten their first dose is very high that they’ll get their second dose. So when I see 81 per cent, I think, ‘Oh, that means that we can get to 81 per cent with two doses.’

Question: What’s the likelihood of outbreaks and how will they be managed moving forward?

Russell: This is a transition period and I’ve heard other people talk about transitioning from pandemic to endemic.

Now that doesn’t mean the pandemic is ending. It is a global pandemic. So the risks will still be there.

We know the importation of cases can and will happen with travel internationally, for sure. And especially if you’re travelling to areas that aren’t vaccinated very well. Some countries just don’t have the capacity. They don’t have the doses and or the uptake isn’t there. So there will be those risks.

The transition right now is that I do expect to see an increased number of cases as time goes by.

But what we expect is that those people who have been vaccinated with two doses of the vaccine, we expect that those people will either be asymptomatic or have very mild symptoms and not have serious symptoms that would require them to be hospitalized or require ICU admission.

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Question: I think today is the number is 18.1 per cent of the eligible population aren’t vaccinated. How much do you worry about them?

Russell: I worry about everyone in New Brunswick. There are so many things that every individual needs to do to help themselves be well. But as a community, as a province, we do have a responsibility and obligation to help our family members, our fellow colleagues and community members to also take steps and actions to be well.

So if you can help your neighbour or your family member book an appointment, if you can help them with giving them a ride, if you can just be there for moral support and encouragement, it’s really important at this time that every New Brunswickers step up and do their part.

They have been so gracious and generous with their trust in our approach and our response throughout the pandemic. I can’t say enough about how privileged it has been and what an honour it’s been to be part of the response and the leadership team.

But now we’re handing the torch back to the citizens of New Brunswick. We’re giving you the opportunity and we’re trusting you to do the right thing.

And the right thing right now is to get vaccinated and help your family and friends get vaccinated.

Question: Do you have any final thoughts?

Russell: It’s been an extraordinary journey and I know people have been sacrificing and working really hard.

We are in a transition period and some people will be anxious about what’s happening after June 30.

And I think we have to be patient and be kind and be compassionate as we go through this transition.

Some of the answers have been edited for length and clarity.

–With a file from The Canadian Press 


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