The last few weeks have seen a major improvement in
Ontario’s daily COVID-19 case account.
The fourth wave seems to have peaked at just under 1,000 daily cases
several weeks ago and for the last seven days has averaged under 500 daily
cases (See Figure). This is at the
bottom of the scenarios that were envisaged just a short while ago as the
fourth wave picked up steam and this may indeed be the beginning of the end of
the pandemic in Ontario. At the same time, we may simply be embarking on a new
post-pandemic era characterized by intermittent ebbs and flows of infection and
a long-term change in how things are done.
In the end, it has been a remarkable learning process.
We appear to owe this new diminished phase of the pandemic partly
to continued public restrictions with respect to the wearing of masks in public
places and the high rates of vaccination. The prolonged restrictions and phased in
reopening over the summer has also been wise given the experience of Alberta
and Saskatchewan with the Delta variant.
The high rates of vaccination in the province have been having their
desired effects and the onset of the vaccine passport system has encouraged
more hold backs to go and get vaccinated.
Yet, there are bumps. The fact
that the new QR code vaccine passport many can download for the first time
today requires iOS 15 - for many of us a new iPhone - means a lot of us are not going to be conveniently loading
it into our Apple Wallets.
And while the provincial government is apparently planning
to announce a further relaxation next week in pandemic restrictions dealing with
capacities in assorted public venues at the same time, it is announcing new
restrictions reflecting slower progress in other areas. The easing of pandemic measures will include
ending capacity limits in
all locations where proof-of-vaccination requirements are in place, such as
restaurants, bars and gyms, a senior official in Ford's government said on Wednesday. To its credit, it is going to retain the
requirement for masking in public spaces.
Moreover, future outbreaks will apparently be met with more local
response as opposed to province wide one size fits all provincial lock downs
though my guess is that is more aspirational given the heavy handed tendency
towards centralization of policy at Queen’s Park.
At the same time, it has been recently announced
that long-term care homes will be instituting testing for staff and visitors
whether doubly vaccinated or not at the same time that it is mandating vaccines
for all long-term care home staff by November 15th. While this continued testing has been out
forth as “random” testing to provide early detection of breakthrough cases, some evidence
to date suggests that Ontario LTC homes will be interpreting it as weekly testing
suggesting that things will not be going back to normal for some time. Calling it "random" may be government political word massage to make visitors to LTC homes think it is not going to be formalized but it remains that the Oxford Dictionary defines random as: "done, chosen, etc. without somebody deciding in advance what is going to happen, or without any regular pattern" and not something done on a weekly basis.
The fact that testing is going to be used on doubly
vaccinated individuals (who granted can still transmit the virus) while some
hospitals have announced that visitors (to be clear not patients) will require double
vaccination to get in to see their loved ones suggests that the real elephant in the
room is still the high proportion of not vaccinated people in Ontario – for which
a lot of other vaccinated people will continue to pay the price. It remains that as of today only 73 percent
of all people in Ontario are fully vaccinated.
And in long-term care homes, as of the latest figures for end of August,
more
than half of homes had less than 90 percent of their staff doubly vaccinated.
So, practice and implementation continue to lag science and evidence
though the other revealing result of this pandemic has been how much public
health, epidemiology and infectious disease science is a lot more like economic
science than they would care to admit. When
it comes to scientific expertise, the pandemic has revealed that we are all
economists now. Economists have been the butt of jokes for years about how
their economic forecasts always seemed off the mark and yet during the
pandemic, epidemiologists, bio-statisticians, and other assorted medical experts,
have joined the ranks of economists and weather forecasters – not just in the
range of forecasts provided but by the constantly shifting advice. One does not have to think that far back to
recall debates and discussion over whether to close border or wait, aerosol transmission
or not aerosol, masks are effective or not effective, take AstraZeneca, don’t
take AstraZeneca, etc.
In the end, this will hopefully be a humbling experience for
science that will improve it. Economic
science, like the other sciences is evidence based and empirical with theoretical frameworks driving the analysis. Facts are indeed facts but interpretation of
the facts via theory and explanation is open to debate, consensus only evolves
over time, and most importantly: decision
and policy making based on the evidence and the conclusions drawn from the
evidence in the end is not done by the scientists but by politicians and civil
servants who have agendas and constraints of their own not least of which is
public reception and compliance. The
decisions in the end have been much more coloured by the art of the possible
than many would have liked. We are indeed at an end but the drama continues.
