Ask the Pharmacist

Q. Just when we thought we were nearing the end of the pandemic, it appears that an overwhelming number of people are sick with COVID now. It has been a while since I have read much about the pandemic. What is the latest news?

A. It is clear that we are currently in our seventh wave of the pandemic in Ontario. Canada’s seven-day rolling average of newly confirmed cases has risen to 3,276 as of Monday. This is up significantly from the less than 2,000 cases we were seeing in mid-June and probably only reflects the tip of the iceberg due to the lack of testing going on.

In the U.S., it is estimated that the actual infection rate is seven times higher than the official count and there is no reason to believe our figures will be far off theirs. This should not come as a surprise to us with the lifting of restrictions and mandates over the last several months.

Back in 2020 when COVID-19 was first making its way around, we did not personally know many people who were getting infected. Today, with the newest variants BA-4 and BA-5 which we believe are so much more contagious (although in the case of BA-5, likely already the dominant variant, we really don’t know much as of yet), you would be hard pressed to not know someone who has been infected recently. In fact, some people are getting re-infected shortly after a previous infection since BA-5 has mutated enough that the body is not able to recognize it and thus offer immunity from it. Thankfully, these latest variants are proving to be not as severe as the original virus was for most of us.

That being said, there are still people that are not coping well with this strain and we should all continue to be vigilant, especially around the elderly and those individuals that are immunocompromised. It is difficult to discern who might be more susceptible to a serious case of COVID. Most of us can make an educated guess on a person’s age but beyond that, since we don’t wear signs informing others of our heath and immune status, we never know when we might be putting someone else at a serious risk.

Though most will get through a COVID infection unscathed, not everyone will be as lucky. To help prevent the unwanted spread of this and future variants, it is strongly advised to continue wearing a mask in indoor settings and close encounters with others, if not for your benefit, then for the safety of your neighbours.

Much like a recent previous infection of COVID does not protect you against these latest variants, fully vaccinated and boosted individuals can also contract BA-5. The vaccines do, however, reduce the severity of the infection and the risk of hospitalization, as they have with all the previous variants. Only about 40% of Canadians have received a third COVID vaccine and with this latest surge of the virus, it is suggested to get your boosters when eligible to continue this fight in the pandemic.

In fact, the NACI (the National Advisory Committee on Immunization), the body that advises our federal government on vaccine policies, is concerned enough about this latest wave that they have gone even further. They are now recommending that anyone over the age of 65, or who is vulnerable (due to congregate housing, social status…) should get a booster this fall “regardless of the number of boosters previously recorded”.

Yes, we are still currently in a pandemic which is hard to fathom after two-plus years. These boosters can not only reduce your severity of the infection but also offer immunity against getting infected for a few weeks and possibly up to a few months.

Public health measures mandate that COVID positive individuals need to isolate at home for the first five days and only leaving isolation after this period if you are both fever-free and your symptoms are improving. Remember to remain masked for an additional five days after this quarantine period is up.

This can be really stressful for some of us. While some people might be able to take that time off of work/school easily, there are many of our neighbours that will struggle to afford the forced time off in these times of high inflation. Hopefully, we as a community, will recognize and support these individuals and their families.

The good news is that reinforcements in our battle against COVID are on the way. Several vaccine manufacturer’s are in the final stages of developing new versions that take into account the more infectious Omicron variants that are now driving cases. These new vaccines have been termed bivalent. Our currently available vaccines are monovalent, aimed solely at the original novel coronavirus.

A bivalent vaccine targets specific mutations in the virus’ spike protein that are seen in both the old strain and the newer Omicron variant. This means that these new vaccines will in essence be a spilt between the old vaccine and a newer version. We already do this annually with the flu vaccine which carry protection against 3 or 4 different strains and hence are termed trivalent or quadrivalent.

Moderna Canada has already submitted its bivalent booster candidate to Health Canada (on June 30th to be exact) for regulatory approval. The goal is to have these Omicron-containing bivalent boosters available for early this fall, but the exact timing of their release is still unclear. There will also be the administration challenges of running three simultaneous vaccine programs at once – a COVID-19 vaccine program for kids younger than 6, this booster program and, of course, the annual influenza shot.

This will be a herculean task, made harder by the fact that much of the infrastructure for mass vaccinations has been removed and health care workers continue to suffer from the strain of being overworked. Let’s hope the Ford government can overcome these obstacles with a well-thought out and adequately funded program. For more information about this or any other health related questions, contact your pharmacist.