COVID-19

What’s in a Name? The Messaging Behind Vaccine Passports in Ontario

Vaccine Passports have been all the rage recently as Ontario Premier Doug Ford announced the plan to implement them earlier this week. The system is set to cover “higher-risk” indoor spaces where masks can’t be worn at all times and will be applied in the following non-essential settings effective September 22, 2021 (Powers & Carter, 2021):

  • Restaurants and bars (excluding outdoor patios, delivery and takeout).
  • Nightclubs, including outdoor areas.
  • Meeting and event spaces like banquet halls and convention centres.
  • Sports and fitness facilities and gyms, with the exception of youth recreational sports.
  • Sporting events.
  • Casinos, bingo halls and gaming establishments.
  • Concerts, music festivals, theatres and cinemas.
  • Strip clubs, bath houses and sex clubs.
  • Racing venues.

The Power of Words

Health experts have recently claimed that the use of the term “passport” is causing more harm than good (Bensadoun, 2021). Ever since the concept of “vaccine passports” were introduced last year, falsified information has and continues to bombard public forums. As such, the level of support towards the implementation of this immunization record system has plummeted. 

Dr. Raywat Deonandan, an epidemiologist and science communicator teaching at the University of Ottawa, claims that passports suggest “restrictions” and that “we [tend to] think of passports [and immediately associate them with] border control. You think of uninformed individuals looking up and down, asking for your papers and restricting you from something you feel you have a right to access” (Bensadoun, 2021).

A Familiar Concept

It is important to remember that vaccine passports-or in other words, immunization records have existed for many years and are common around the world. In most provinces in Canada, public schools will require proof of a child’s immunization record in order to attend. 

In the words of Maxwell Smith, a bioethicist and professor at Western University, “people feel that their liberties are being infringed upon with these sort of systems, despite the fact that we have always ordered society in the name of public health with particular protections that protect populations and we view vaccination status as one of those ways to do that” (Bensadoun, 2021).

References

Bensadoun, E. (2021, September 8). ‘Vaccine passport’ or ‘immunization record’? Why experts say there’s power in words – national. Global News. Retrieved September 9, 2021, from https://globalnews.ca/news/8171936/vaccine-passport-language-concerns/.

Powers, L., & Carter, A. (2021, September 2). Ontarians will need to show proof of COVID-19 vaccination for indoor DINING, GYMS, Theatres | CBC News. CBCnews. Retrieved September 9, 2021, from https://www.cbc.ca/news/canada/toronto/ontario-covid-vaccine-passport-certificate-proof-1.6160728.

About the Author

Bairavie Piravakaran (she/her) is a second-year undergraduate at the University of Toronto Scarborough. As a Psychological & Health Sciences student, she values the importance of sharing credible information and making health resources more accessible to the public. Her interests in population health, research, and design are also reflected in her non-academic pursuits—she currently with the Young Leaders of Public Health and Medicine (YLPHM) as a Social Media Manager for the Scarborough Chapter and is a Health Promotion & Analytics Member at Critical Health Innovations Lab (CHIL). At EMPOWER Health, Bairavie works closely with the Marketing Team in order to plan and execute strategies that help inform the public about current health-related topics.

“No Jab, no job?”: Mandating Vaccines at Work

There has been ongoing debate on whether mandating vaccines in general is the most ethical approach to immunization. With the recent surge of COVID-19 cases however, many employers are now requiring employees to receive their vaccines in order to be able to continue to work. This is following Ontario’s chief medical officer of health’s release of new vaccination guidelines for healthcare and education sectors.

According to the new guidelines, starting September 7, 2021, all employees, staff, contractors, students, volunteers from high risk-settings such as ambulance services at hospitals and in-home and community care services will be required to show proof of vaccination or a medical reason for not being vaccinated (Ontario Newsroom, 2021). Those who choose not to provide proof of vaccination with two doses will be required to take an antigen COVID-19 test and complete an educational session (Ontario Newsroom, 2021).

Is this new policy effective?

The University Health Network (UHN) has recently confirmed that its current employees who are still unvaccinated by the end of October will be terminated (DeClerq, 2021). The health network’s CEO Kevin Smith claims that this newly implemented policy has led to a significant increase in vaccinations, as the percentage of vaccinated employees rose from 85% in late July to what is now 92% (DeClerq, 2021). Daniel Lublin, a Toronto-based employment lawyer, applauds UHN for making it clear as to what will happen if an employee refuses to receive a COVID-19 vaccine (DeClerq, 2021).

The ongoing dispute

While these new guidelines seem to be effective in convincing more individuals to get their shot, the real question is whether employers actually have the right to impose such vaccination mandates. The other concern is what happens to employees who are unable to get vaccinated due to physical and/or medical conditions. 

As such, it becomes clear that implementing new guidelines are not as black an white as the “no jab, no job” policy. In a recent CTV interview, employment lawyer Jon Pinkus states that “Employers are not obligated by law to have their employees vaccinated,” but until then, “many employers will likely be dealing with a high volume of disputes from employees” (Cranston, 2021). 

References

Cranston, M. (2021, August 24). No jab, no job? Experts weigh in on legality of vaccine mandates at private companies. British Columbia. https://bc.ctvnews.ca/no-jab-no-job-experts-weigh-in-on-legality-of-vaccine-mandates-at-private-companies-1.5558766.

DeClerq, K. (2021, August 21). Unvaccinated employees at Toronto hospital network told they will be fired. Toronto. https://toronto.ctvnews.ca/unvaccinated-employees-at-toronto-hospital-network-told-they-will-be-fired-1.5555653.

Ontario Newsroom. (2021, August 17). Ontario Makes COVID-19 Vaccination Policies Mandatory for High-Risk Settings. Ontario Newsroom. https://news.ontario.ca/en/release/1000750/ontario-makes-covid-19-vaccination-policies-mandatory-for-high-risk-settings.

About the Author

Bairavie Piravakaran (she/her) is a second-year undergraduate at the University of Toronto Scarborough. As a Psychological & Health Sciences student, she values the importance of sharing credible information and making health resources more accessible to the public. Her interests in population health, research, and design are also reflected in her non-academic pursuits—she currently with the Young Leaders of Public Health and Medicine (YLPHM) as a Social Media Manager for the Scarborough Chapter and is a Health Promotion & Analytics Member at Critical Health Innovations Lab (CHIL). At EMPOWER Health, Bairavie works closely with the Marketing Team in order to plan and execute strategies that help inform the public about current health-related topics.

An update on reopening post-secondary institutions

As the start of the 2021 Fall semester is fast approaching, many Ontarian post-secondary institutions have begun releasing their statements in regard to how they are going to approach reopening amidst the fourth wave of COVID-19. The following are some of the most recent updates from Ontario’s largest institutions:

University of Toronto

Starting Fall 2021, most classes, labs and tutorials will take place virtually. While the University of Toronto encourages all members of the community to become vaccinated, only students living in residence for 2021-2022 will be required to get their first dose of a COVID-19 vaccine before their residence move-in date  (University of Toronto, 2021). The University of Toronto strongly recommends that students receive their vaccine at least 14 days before moving in. According to the latest news report, “those who are unable to get vaccinated before moving in will have two weeks following their move-in date to receive their first dose, with the university helping to facilitate access to vaccines, subject to supply” (Kalvapelle, 2021). The University continues to remain hopeful about the return of in-person classes, student services and co-curricular activities this September and will continue to follow all public health guidelines (University of Toronto, 2021).

Western University

Western University has a similar vaccination policy to that of UofT,  with a mandate for all students living on campus to have received their first dose no later than Monday, September 13th, 2021 – one week after the first day of school. The University is preparing for a full return to in-person classes but also claims that the Fall/Winter 2020-2021 course offerings may be subject to change. The university will also be offering on-campus vaccination and testing centres to provide first and second doses for students, staff, and faculty members (Western University, 2021). 

McMaster University

At McMaster University, course delivery in Fall 2021 will consist of a hybrid of in-person and online elements; on-campus activities will be modified and residences will also be open. Masking indoors will continue to be required as per public health guidelines. Vaccines will also become mandatory as of September 7 in order to utilize campus facilities. The official statement reads that “Those who are not yet fully vaccinated, or who have not yet received an exemption for a validated human rights ground, will be required to submit proof of a negative COVID test result twice a week. This testing protocol will be in place until October 18 when vaccines or an approved exemption will be needed to attend a McMaster campus or facility” (McMaster, 2021). 


Waterloo University

Effective September 1, 2021, all University of Waterloo visitors will be required to declare their vaccination status, and those that do not report being vaccinated must undergo regular COVID testing (University of Waterloo, 2021). The process to declare vaccination status will be mandatory for anyone coming on to campus. The University will require all visitors to provide an attestation that the information regarding their vaccination status is accurate and truthful. Those who are not vaccinated or choose not to answer will also be asked to provide an attestation that declares their consent to participate in the rapid antigen screening program (University of Waterloo, 2021).

References

Kalvapalle, R. (2021). U of t to require covid-19 vaccinations for students living in residence. University of Toronto News. https://www.utoronto.ca/news/u-t-require-covid-19-vaccinations-students-living-residence.

McMaster University. (2021, August 16). McMaster requires proof of vaccination and MANDATORY Vaccines: A letter from the president and Provost – Covid-19 (coronavirus). COVID. https://covid19.mcmaster.ca/mcmaster-requires-proof-of-vaccination-and-mandatory-vaccines-a-letter-from-the-president-and-provost/.

University of Toronto. (2021). Your guide to FALL 2021 at U of T. Resources for students for fall 2021 | University of Toronto. https://www.utoronto.ca/utogether/resources-for-students.

University of Waterloo. (2021, August 16). Mandatory vaccination and attestation. COVID-19 Information. https://uwaterloo.ca/coronavirus/news/mandatory-vaccination-and-attestation.

Western University. (2021). COVID-19 information for the campus community. COVID-19 Updates – Western University. https://www.uwo.ca/coronavirus/faqs.html.

About the Author

Bairavie Piravakaran (she/her) is a second-year undergraduate at the University of Toronto Scarborough. As a Psychological & Health Sciences student, she values the importance of sharing credible information and making health resources more accessible to the public. Her interests in population health, research, and design are also reflected in her non-academic pursuits—she currently with the Young Leaders of Public Health and Medicine (YLPHM) as a Social Media Manager for the Scarborough Chapter and is a Health Promotion & Analytics Member at Critical Health Innovations Lab (CHIL). At EMPOWER Health, Bairavie works closely with the Marketing Team in order to plan and execute strategies that help inform the public about current health-related topics.

The Third COVID-19 Shot: Yay or Nay?

Pfizer’s latest data has suggested that a third dose of its COVID-19 vaccine would strongly boost protection against the Delta variant, even more so than two doses alone. 

The unofficial Pfizer data indicates that antibody levels against the Delta variant in those aged 18 to 55 after receiving a third dose of vaccine are higher than for those who have only received their second dose (Howard, 2021). For those aged 65 to 85, the antibody response was even higher (Howard, 2021).

Extra doses in Quebec

The Quebec government is currently offering an extra dose of an mRNA vaccine to those who are looking to travel to countries that don’t recognize their vaccination status (CBC, 2021). As there are certain countries that don’t recognize people as being fully vaccinated if they have received two different COVID-19 vaccines, this has become a concerning issue for the approximate 1.3 million Canadians who have mixed and matched. Health officials have repeatedly mentioned that it is the recipient’s discretion to “seek advice and weigh the risks” prior to receiving a third dose (CBC, 2021).

Robert Maranda, a spokesman for the Health Department states that there are no studies assessing the impact of receiving three doses of two separate vaccines and that “the person should be properly counselled to be informed of the potential risks associated with this added dose compared to the benefits of the planned trip,” (CBC, 2021).


Hope for the immunocompromised


While a third dose may not be recommended for everyone, recent data has shown that it may be beneficial to those who are immunocompromised. According to a world first study, a third dose of the COVID-19 vaccine could provide significantly greater protection against the SARS-CoV-2 virus in transplant patients (Favaro et al., 2021). Because transplant recipients’ immune systems are typically “unable to mount an adequate response to immunization”, they are much more prone to infectious diseases such as COVID-19 (Favaro et al., 2021). As such, the promising results from testing the third dose on transplant patients provides hope for other individuals who are immunocompromised due to other medical conditions.

What are health officials saying?

As of now, there is not enough evidence to demonstrate that a third dose of the COVID-19 vaccine is necessary. In the words of the National Advisory Committee on Immunization (NACI), “there is currently no evidence on the need for booster doses of COVID-19 vaccine after the vaccine series is complete” (CBC, 2021). 

NACI does however recommend that the same mRNA vaccines are used for a second dose, but also ensures that mRNA shots are considered interchangeable should the first type be unavailable (CBC, 2021). Additionally, NACI mentions that any of the approved mRNA options are actually preferred as a second dose regardless of the type of vaccine that was received for the first (CBC, 2021). This is a result of emerging safety evidence and the possibility that having at least one dose of an mRNA vaccine may produce a better immune response (CBC, 2021). 

At the end of the day, it is the individuals’ responsibility to weigh the risks of receiving a third dose. That being said, it would be in your best interest to consult with a primary health physician beforehand in order to make an informed decision.

References

CBC/Radio Canada. (2021, July 27). Quebec offers extra dose to travellers whose vaccination status isn’t recognized | CBC News. CBCnews. https://www.cbc.ca/news/health/quebec-third-dose-covid-vaccine-travel-1.6117954.

Favaro, A., Philip, E. S., & Dunham, J. (2021, August 11). Third COVID-19 vaccine dose effective and safe for transplant Recipients: Study. Coronavirus. https://www.ctvnews.ca/health/coronavirus/third-covid-19-vaccine-dose-effective-and-safe-for-transplant-recipients-study-1.5543323.

Howard, J. (2021, July 28). Pfizer claims 3rd DOSE ‘strongly’ BOOSTS protection against Delta variant. Coronavirus. https://www.ctvnews.ca/health/coronavirus/pfizer-claims-3rd-dose-strongly-boosts-protection-against-delta-variant-1.5526101.

About the Author

Bairavie Piravakaran (she/her) is a second-year undergraduate at the University of Toronto Scarborough. As a Psychological & Health Sciences student, she values the importance of sharing credible information and making health resources more accessible to the public. Her interests in population health, research, and design are also reflected in her non-academic pursuits—she currently with the Young Leaders of Public Health and Medicine (YLPHM) as a Social Media Manager for the Scarborough Chapter and is a Health Promotion & Analytics Member at Critical Health Innovations Lab (CHIL). At EMPOWER Health, Bairavie works closely with the Marketing Team in order to plan and execute strategies that help inform the public about current health-related topics.

Is Canada heading towards a fourth wave?

The short answer is yes, but the real question is how severe the resurgence of COVID-19 cases will be. According to Canada’s latest modelling, the fourth wave is set to be driven by the delta variant; its impact on the general public, however, will directly correlate with the number of people who are fully vaccinated (Aiello, 2021).

The pandemic of the unvaccinated

The Ontario Hospital Association (OHA) has also warned that the upcoming surge in COVID case numbers could become a great threat to the province (Johnson, 2021). Ontarians who have yet to receive two doses are now considered to be the most vulnerable population. Officials are calling this upcoming fourth wave “the pandemic of the unvaccinated” (Johnson, 2021).

“The updated longer-range forecast shows how the epidemic trajectory may evolve through early September. It suggests that we are at the start of the Delta-driven fourth wave, but that the trajectory will depend on ongoing increases in fully vaccinated coverage, and the timing, pace and extent of reopening,” – Dr. Theresa Tam, Chief Public Health Officer of Canada

A Disproportionate Impact

In a recent interview,  Federal Indigenous Services Minister Marc Miller expresses his concern as he fears that this Delta-driven fourth wave would heavily impact marginalized communities, especially Indigenous peoples (Malone, 2021). According to Miller, a large portion of Indigenous peoples, particularly those living on reserves, are children under the age of 12, who are not eligible to get a dose (Malone, 2021). The biggest threat to unvaccinated individuals however, is the rising number of delta variant cases. 

Outbreaks of the Delta variant have already begun to pop up on reserves within the past few weeks. In northern Saskatchewan, the Black Lake First Nation went into lockdown last month as the Delta variant spread rapidly and affected around 1600 individuals (Malone, 2021).The Athabasca Health Authority also claims that the number of cases this week reached over 200—ultimately requiring those living in affected areas to self-isolate (Malone, 2021).

Taking a closer look at the numbers

Hospitalization rates across the region have continued to remain low, with less than 1% of hospitalized cases occurring in people who are fully vaccinated (Aiello, 2021). That being said, 89.7% of all hospitalized cases occurring in unvaccinated people are those who are eligible to receive the vaccine (Aiello, 2021). 

Out of the 84.9 % hospitalized cases who are unvaccinated, 5.3%of cases are those who are not yet eligible for vaccines, and 4.6% are those who are partially vaccinated. (Aiello, 2021)

“I think it’s going to be primarily be younger unvaccinated children [affected], and of course the adults who have chosen not to get the vaccine,” – Dr. Steve Flindall, York Region Emergency Physician

To book your COVID-19 vaccination, visit iamsick.ca!

References

Aiello, R. (2021, July 30). Canada is heading towards a ‘Delta-driven’ FOURTH Wave, tam says. Coronavirus. https://www.ctvnews.ca/health/coronavirus/canada-is-heading-towards-a-delta-driven-fourth-wave-tam-says-1.5529290.

Johnson, N. (2021, August 4). Ontario hospitals begin to brace for fourth wave of covid-19. Toronto. https://toronto.ctvnews.ca/ontario-hospitals-begin-to-brace-for-fourth-wave-of-covid-19-1.5534889.

Malone, K. G. (2021, August 4). Indigenous Minister worries lifting COVID-19 restrictions could bring fourth wave. Coronavirus. https://www.ctvnews.ca/health/coronavirus/indigenous-minister-worries-lifting-covid-19-restrictions-could-bring-fourth-wave-1.5534383.

About the Author

Bairavie Piravakaran (she/her) is a second-year undergraduate at the University of Toronto Scarborough. As a Psychological & Health Sciences student, she values the importance of sharing credible information and making health resources more accessible to the public. Her interests in population health, research, and design are also reflected in her non-academic pursuits—she currently with the Young Leaders of Public Health and Medicine (YLPHM) as a Social Media Manager for the Scarborough Chapter and is a Health Promotion & Analytics Member at Critical Health Innovations Lab (CHIL). At EMPOWER Health, Bairavie works closely with the Marketing Team in order to plan and execute strategies that help inform the public about current health-related topics.

Crunching COVID Numbers: What to Expect this Fall

Ontario’s Chief Medical Officer of Health Dr. Kieran Moore claims that he “absolutely” expects a rise in COVID-19 cases in September and that Ontario will be preparing for the potential surge (Davidson, 2021).

Fall is right around the corner—and so is flu season. As most people tend to spend a great amount of time indoors due to colder temperatures, many respiratory viruses will also begin to spread around mid to late September (Davidson, 2021). It is crucial for Ontario to amp up its immunization rates by September so that Ontarians can safely take part in indoor activities (Davidson, 2021).

According to the Ontario Ministry of Health’s COVID-19 Daily Epidemiologic Summary, COVID-19 infections have recently jumped well over the 100 count (Tsekouras, 2021). The majority of these new cases were found in Toronto and Hamilton (Tsekouras, 2021). Other affected areas include Waterloo, Peel Region, York Region, Durham Region, Halton Region, and Wellington-Dufferin-Guelph (Tsekouras, 2021).  As of July 28, 2021, there were 218 new cases reported in Ontario (Fox, 2021).

Update on COVID-19 Variants

As of last week, 234 cases of COVID-19 variants of concern (VOC) were reported in Ontario (Tsekouras, 2021). At least 99 of those 234 cases were of the Alpha variant, about 69 of them were of the Gamma variant, 61 cases of the Delta variant, and 5 of them were of the Beta variant (Tsekouras, 2021).

Looking Ahead

Dr. Moore seems confident that Ontario will be able to reach its desired targets and move forward from stage 3 before August 6th, 2021. In order to surpass stage 3 however, at least 80% of those eligible for vaccines need to have received their first dose, and 75% should have their second (Davidson, 2021). Moreover, the province will be remaining in this stage for a minimum of 21 days before most public health restrictions are lifted (Tsekouras, 2021). As such, Ontarians will need to keep up with their COVID-19 vaccines to be well-prepared for the fall.

“It’s a challenge to all Ontarians. If we want to get through to the next phase of reopening, which is a complete reopening with no public health measures, we’ve got work cut out for us.” – Dr. Kieran Moore

For those looking to get vaccinated against COVID-19, visit iamsick.ca to book your appointment.

References

Davidson, S. (2021, July 13). Ontario’s top doctor ‘absolutely’ expects rise IN COVID-19 cases in September. Toronto. https://toronto.ctvnews.ca/ontario-s-top-doctor-absolutely-expects-rise-in-covid-19-cases-in-september-1.5507695.

Fox, C. (2021, July 29). Ontario reports highest number of new COVID-19 cases in more than three weeks. CP24. https://www.cp24.com/news/ontario-reports-highest-number-of-new-covid-19-cases-in-more-than-three-weeks-1.5527730.

Tsekouras, P. (2021, July 22). Ontario reports jump in new COVID-19 infections but case numbers remain below 200. Toronto. https://toronto.ctvnews.ca/ontario-reports-jump-in-new-covid-19-infections-but-case-numbers-remain-below-200-1.5519069.

About the Author

Bairavie Piravakaran (she/her) is a second-year undergraduate at the University of Toronto Scarborough. As a Psychological & Health Sciences student, she values the importance of sharing credible information and making health resources more accessible to the public. Her interests in population health, research, and design are also reflected in her non-academic pursuits—she currently with the Young Leaders of Public Health and Medicine (YLPHM) as a Social Media Manager for the Scarborough Chapter and is a Health Promotion & Analytics Member at Critical Health Innovations Lab (CHIL). At EMPOWER Health, Bairavie works closely with the Marketing Team in order to plan and execute strategies that help inform the public about current health-related topics.

You probably aren’t going to read this entire blog post.

And that’s totally fine. But here’s a recent example of why you should always read beyond the headlines:

Last week, WHO Chief Scientist Dr. Soumya Swaminathan was quoted out of context. In Swaminathan’s original statement, the warning in regard to mixing COVID-19 vaccines was given to those who are already fully vaccinated and may be deciding for themselves if they need an extra “booster” dose (CBC News, 2021). The media’s representation of Dr. Swaminathan’s statement, however, failed to provide context as headlines along the lines of “WHO Warns Against Mixing and Matching COVID-19 Vaccines” flooded the internet. 

With one thing leading to another, false rumors about mixing and matching vaccines had essentially spread across the globe. What was initially given as a warning, had quickly escalated into a chaotic situation of broken telephone in which Canadians were beginning to doubt their own country’s vaccination strategy—which includes mixing and matching vaccines (CBC News, 2021). In a tweet following the press conference, Dr. Swaminathan clarified that mixing vaccines is completely safe and that public health agencies, not individuals, should make decisions on mixing and matching COVID vaccines, based on available data (Reuters, 2021). 

TLDR: “Context is extremely important.”

According to infectious disease specialist Dr. Isaac Bogoch, if there’s one thing to take away from this situation, it’s to always remember that “context is extremely important.” In his interview with CBC News, Bogoch states that WHO officials “were really referring to people who had already received, for example, a full course of a vaccine series and then were, you know, for lack of a better word, choosing their own adventure and trying to get additional doses of a vaccine” (CBC News, 2021).

References

CBC News. (2021, July 14). What the World Health Organization really said about mixing COVID-19 vaccines | CBC News. CBCnews. https://www.cbc.ca/news/health/covid-19-vaccine-mixing-and-matching-who-1.6101047.

Reuters. (2021, July 12). WHO warns individuals against mixing and matching COVID vaccines. Reuters. https://www.reuters.com/business/healthcare-pharmaceuticals/who-warns-against-mixing-matching-covid-vaccines-2021-07-12/?taid=60ec9968fdc7d300011ff877&utm_campaign=trueAnthem%3A%2BTrending%2BContent&utm_medium=trueAnthem&utm_source=twitter.

About the Author

Bairavie Piravakaran (she/her) is a second-year undergraduate at the University of Toronto Scarborough. As a Psychological & Health Sciences student, she values the importance of sharing credible information and making health resources more accessible to the public. Her interests in population health, research, and design are also reflected in her non-academic pursuits—she currently with the Young Leaders of Public Health and Medicine (YLPHM) as a Social Media Manager for the Scarborough Chapter and is a Health Promotion & Analytics Member at Critical Health Innovations Lab (CHIL). At EMPOWER Health, Bairavie works closely with the Marketing Team in order to plan and execute strategies that help inform the public about current health-related topics.

The Long Haul: Post-COVID-19 Conditions

The SARS-CoV-2 virus has directly impacted over 185 million people worldwide (including those who have deceased as a result of the virus). With just over 4 million of those 185 million+ cases being fatal (Ritchie et al., 2020), the remaining individuals are notoriously those who have supposedly recovered from their initial COVID-19 symptoms. Recently however, a number of these “recovered individuals” have reported experiences of post-COVID-19 conditions.

What are Post-COVID-19 Conditions?

Post-COVID-19 conditions, otherwise known as long COVID-19, post-acute COVID-19, or chronic COVID-19, involve a number of new and/or persisting symptoms that occur “four or more weeks after first being infected” with the SARS-CoV-2 virus (CDC, 2021). While post-COVID-19 conditions have a tendency to affect those who experienced severe illness during their infectious period, these symptoms can affect anyone who has had COVID-19—regardless of whether or not they were asymptomatic during their infectious period (CDC, 2021). The Centers for Disease Control and Prevention (CDC) has compiled a list of some the most commonly reported symptoms:

  • Difficulty breathing or shortness of breath
  • Tiredness or fatigue
  • Symptoms that get worse after physical or mental activities
  • Difficulty thinking or concentrating (sometimes referred to as “brain fog”)
  • Cough
  • Chest or stomach pain
  • Headache
  • Fast-beating or pounding heart (also known as heart palpitations)
  • Joint or muscle pain
  • Pins-and-needles feeling
  • Diarrhea
  • Sleep problems
  • Fever
  • Dizziness on standing (lightheadedness)
  • Rash
  • Mood changes
  • Change in smell or taste
  • Changes in period cycles

Who is at risk?

It is common for many to assume that the older population and/or those with pre-existing health conditions are at a higher risk for experiencing post-COVID-19 conditions. While this is most likely true, a recent study conducted by researchers from the University of Bergen in Norway reveals that long-term symptoms after having mild COVID-19 can also impact young people (Neustaeter, 2021). 

After analyzing the symptoms of 312 COVID-19 patients six months post-COVID infection, the study found that 61% of these patients experienced post-COVID-19 conditions (Neustaeter, 2021). Moreover, 52% of patients between the ages of 16 and 30 who suffered mild COVID-19 infection reported prolonged symptoms that included but were not limited to, loss of taste/smell, fatigue, shortness of breath, and impaired concentration (Neustaeter, 2021). The study mentions that these symptoms were “independently associated with severity of the initial illness, pre-existing conditions and increased convalescent antibodies” (Neustaeter, 2021). 

“The cognitive symptoms of impaired memory and concentration difficulties are particularly worrying for young people at school or university and [ultimately] highlights the importance of vaccination to prevent the long-term health implications of COVID-19.”

  • Bjorn Blomberg 

Multiorgan and Autoimmune Conditions

Those who experience severe COVID-19 illness during their infectious period may also experience multiorgan effects and/or autoimmune conditions post-infection. Multiorgan effects can involve damage to the body systems, including a combination of heart, lung, kidney, skin, and brain functions (CDC, 2021). Autoimmune conditions on the other hand occur when the immune system misinterprets and attacks healthy cells, ultimately causing inflammation and/or tissue damage (CDC, 2021). 

Associate professor and study author Bjorn Blomberg claims that more research is needed to further assess the long-term impacts of the disease on other organs (Neustaeter, 2021). Based on the Norway study findings, he adds that it is crucial to understand the need for vaccines and other infection control measures—not just for the older population, but for younger age groups as well.

References

Centers for Disease Control and Prevention. (2021). Post-COVID Conditions. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html.

Neustaeter, B. (2021, June 23). Young adults with mild COVID-19 suffering from persistent symptoms six months after infection: study. CTV News. https://www.ctvnews.ca/health/coronavirus/young-adults-with-mild-covid-19-suffering-from-persistent-symptoms-six-months-after-infection-study-1.5482892.

Ritchie, H., Ortiz-Ospina, E., Beltekian, D., Mathieu, E., Hasell, J., Macdonald, B., Giattino, C., Appel, C., Rodés-Guirao, L., & Roser, M. (2020, March 5). Coronavirus Pandemic (COVID-19) – the data – Statistics and Research. Our World in Data. https://ourworldindata.org/coronavirus-data.

About the Author

Bairavie Piravakaran (she/her) is a second-year undergraduate at the University of Toronto Scarborough. As a Psychological & Health Sciences student, she values the importance of sharing credible information and making health resources more accessible to the public. Her interests in population health, research, and design are also reflected in her non-academic pursuits—she currently with the Young Leaders of Public Health and Medicine (YLPHM) as a Social Media Manager for the Scarborough Chapter and is a Health Promotion & Analytics Member at Critical Health Innovations Lab (CHIL). At EMPOWER Health, Bairavie works closely with the Marketing Team in order to plan and execute strategies that help inform the public about current health-related topics.

Is It Safe to Gather With Others During The COVID-19 Pandemic? Use This Tool to Find Out: CovidVisitRisk.com

The Visit Risk Calculator (CovidVisitRisk.com) is a new assessment tool launched by the NIA (National Institute of Ageing) in partnership with the Government of Canada to help Canadians assess the risk-level associated with social gatherings.

Using the best available scientific evidence and the input of leading experts in infectious diseases, public health and epidemiology, the website was developed to help people of different ages and states of health better understand the factors that affect the risk of getting COVID-19 when visiting or gathering with others.

As vaccination programs ramp up across the country, restrictions are slowly loosening. Canadians want more guidance on what fully-vaccinated people can do safely. Chief public health officer Dr. Theresa Tam says, “We would like to enable people to take themselves through [this] kind of risk assessment while respecting local public health requirements.”

To use the tool, you will be asked a series of questions related to your vaccination and health status, and that of the people you want to gather with, details of the event and what the local infection rates are.

“This tool uses the best available scientific evidence to support people of all ages and states of health to make more informed decisions about gathering with others during the pandemic,” says Dr. Samir Sinha, NIA Director of Health Policy Research. “After working through the questions, people are assigned a risk level in accordance with the gathering they are considering, along with public health advice on how to meet more safely with others.”

Based on your answers, you will get a “risk score” from Low to High, a personalized report to help you understand the level of risk associated with your planned visit or gathering, and tips on how to make your visit or gathering as safe as possible for the duration of the COVID-19 pandemic. 

The vision behind the tool is to prepare you and your loved ones to better discuss the potential risks and benefits of visiting or gathering with each other and in the end make a well-informed decision on how to make any necessary visits or gatherings as safe as possible.

“These risk assessments depend on your individual risk, who you’re about to get into contact with, as well as the epidemiology of your specific community,” says Dr. Theresa Tam.

As of June 25th 2021, 75% of the population 12 years and older has received at least one dose and 22% is fully vaccinated. However, COVID-19 remains an important public health issue as transmission with new variants of concern continue to circulate. Careful assessment before deciding to visit, gather, or meet with others remains vitally important.

To learn more about the COVID-19 Risk Calculator or to use it for yourself, click here.

Disclosure: EMPOWER Health helped the NIA build the online experience of the risk assessment tool, and provided technical guidance along with testing.  As always, our team is proud of our work with Public Health Organizations to help conquer COVID! Visit us at empower.ca!

References

Rabson, M. (2021, June 22). Risk-assessment tool for fully vaccinated people coming soon, Tam promises. Ctvnews.ca. https://www.ctvnews.ca/health/coronavirus/risk-assessment-tool-for-fully-vaccinated-people-coming-soon-tam-promises-1.5481082

Vaccination Hesitancy: Know Your Risks

Although vaccination hesitancy has been a great concern for decades, the COVID-19 vaccine rollout has increased speculation surrounding the likelihood of adverse and potentially fatal effects that vaccines may cause. In a recent Canadian study, vaccination hesitancy has been demonstrated to stem from individual safety, concerns with political and economic factors driving the vaccine rollout, having limited knowledge about vaccines in general, misleading and false information, as well as a lack of legal liability from vaccine companies. Moreover, there is a demonstrated level of mistrust due to health care institutions’ history of neglecting and ultimately marginalizing communities with fewer resources (Griffith et. al, 2021). According to the World Health Organization (WHO), one of the worst threats to global health is vaccination hesitancy. 

Seconds Anyone?

With Canada putting a pause on AstraZeneca distributions to new recipients, there has been recent controversy on whether those who have already received their first dose are at any significant risk. Public health officials have assured that those who have taken the AstraZeneca vaccine did the right thing at the time and should not feel remorse for acting quickly to receive their first shot (Arthur, 2021).

The real discussion, however, is what the next steps are for those who have already received their first dose—whether to proceed with their second dose of AstraZeneca or to mix and match with a dose of an mRNA vaccine such as Pfizer-BioNTech or Moderna. According to a recent Spanish trial of over 600 participants, those who had received the Pfizer vaccine after taking their first dose of the AstraZeneca vaccine demonstrated a significantly greater antibody response (Callaway, 2021). However, it is still unclear how these results will compare to the antibody response from combining two different mRNA vaccines. While researchers seem to agree that mixing vaccines could provide a better overall immune response, there is currently no concrete evidence on whether mixing vaccines in general is a better option than taking a second dose of the same vaccine.  

If you have already taken the AstraZeneca vaccine and/or have underlying conditions, it is in your best interest to consult with your primary physician to help determine what the best option is for you.

Weighing the Risks

A concept that many may find difficult to digest is that the risk of contracting severe COVID-19 is substantially greater than the risks associated with a COVID-19 vaccine. Long story short, it is highly recommended to get the vaccine if you are eligible and have the means to do so because, at this point in time, your chances of ending up in the ICU are much higher than experiencing severe side effects from a vaccine. With over 19 million Canadians already receiving their first dose of the COVID-19 vaccine, there appears to be a light at the end of the tunnel. That being said, vaccination hesitancy is still a growing concern and needs to be addressed through the implementation of public health interventions that work to educate, resolve concerns, and rebuild trust in our healthcare system. 

At the end of the day, all vaccines come with their own set of risks and side effects. While it is important to be well aware of these individual risks, it is crucial to understand that receiving a COVID-19 vaccine not only provides individual benefits but also alleviates stress on hospitals and benefits the population as a whole. If we want to #conquercovid we need to have as many people vaccinated as possible; the more people who are hesitant and choose to “wait”, the longer it will take to reduce the number of cases and return to normal. 

References

Arthur, B. (2021, May 12). Why pausing AstraZeneca was the right move – and why you probably were right to get it. thestar.com. https://www.thestar.com/opinion/star-columnists/2021/05/11/why-ontario-made-the-right-move-by-pausing-astrazeneca-vaccines-and-why-if-you-got-it-you-probably-did-the-right-thing.html. 

Callaway, E. (2021, May 19). Mix-and-match COVID vaccines trigger potent immune response. Nature News. https://www.nature.com/articles/d41586-021-01359-3.

Griffith, J., Marani, H., & Monkman, H. (2021). COVID-19 Vaccine Hesitancy in Canada: Content Analysis of Tweets Using the Theoretical Domains Framework. Journal of Medical Internet Research, 23(4). https://doi.org/10.2196/26874

Bibliography

Ferguson, R. (2021, May 11). Ontario pauses first doses of AstraZeneca over clot concerns. thestar.com. https://www.thestar.com/politics/provincial/2021/05/11/covid-19-vaccines-for-teens-coming-soon-but-adults-still-a-priority-ontario-says.html.

Bairavie Piravakaran (she/her) is a second-year undergraduate at the University of Toronto Scarborough. As a Psychological & Health Sciences student, she values the importance of sharing credible information and making health resources more accessible to the public. Her interests in population health, research, and design are also reflected in her non-academic pursuits—she currently volunteers with the Young Leaders of Public Health and Medicine (YLPHM) as a Social Media Manager for the Scarborough Chapter and is a Health Promotion & Analytics Member at Critical Health Innovations Lab (CHIL). At EMPOWER Health, Bairavie works closely with the Marketing Team in order to plan and execute strategies that help inform the public about current health-related topics.