Fully vaccinated Americans have had looser restrictions for months. Why don't Canadians?
TORONTO -- It's been more than three months since the U.S. Centers for Disease Control (CDC) first told Americans what they can safely do once they are fully vaccinated.
When the CDC released its guidance in March, roughly nine per cent of Americans had received a second shot of a COVID-19 vaccine. With more than 14 per cent of Canadians now fully vaccinated themselves, some experts are saying it's time for the federal government to clearly outline what is and is not allowed for those who have had two doses.
"We need to have something more concrete from the federal government to show what people can do safely," Dr. Sumon Chakrabarti, an infectious diseases physician at Trillium Health Partners in Mississauga, Ont., said Wednesday on CTV's Your Morning.
To this point, the only social advantage the government has announced for the fully vaccinated is the ability to skip stays in quarantine hotels and long self-isolation periods after flying back into the country. As announced last week, Canadians who have received two doses of vaccine here will instead only have to self-isolate at home until they test negative for the novel coronavirus.
Even this measure is not set in stone; Health Minister Patty Hajdu said that it may start as early as July, depending on what Canada's COVID-19 infection and vaccination statistics look like at the time.
Hajdu told CTV's Question Period in May that the federal government would "shortly" be releasing advice on what Canadians could do after receiving one or two doses of a vaccine, but more recently said that it is up to provincial health authorities to issue those sorts of recommendations.
The federal government has said that it would not be safe for provinces to start rolling back restrictions until 75 per cent of the population have had one dose of a vaccine and 20 per cent have had two doses. Dr. Theresa Tam, Canada's chief public health officer, said Tuesday that those thresholds may have to be increased due to the highly transmissible Delta variant.
PRESERVING HOSPITALS, AVOIDING MIXED MESSAGES
Experts say that both infection and vaccination rates are important when it comes to lifting public health restrictions. The goal of lockdowns and similar health measures is to limit the spread of the virus in order to preserve hospital capacity. If vaccination uptake is high but the virus is still spreading among the few unvaccinated, there could still be a significant strain on the health-care system.
What is promising on that front, Chakrabarti said, is data showing that even one dose of vaccine makes a significant difference when it comes to hospitalization and other serious consequences of contracting COVID-19 – suggesting it might be safer than first thought to lift some restrictions before the majority of Canadians are fully vaccinated.
"The vaccine is still working to prevent severe disease, and that's the most important outcome," he said.
More than 65 per cent of Canadians had received at least one dose of a COVID-19 vaccine as of Tuesday night, based on figures from Our World in Data – a higher percentage than that of any other country with at least five million inhabitants.
Chakrabarti expressed concern that if no Canadian guidance is forthcoming, individual provinces might start to develop their own rules – and they may not be in step with any eventual federal recommendations.
"When you start to have mixed messaging – the federal government saying one thing, provincial governments saying something else – [it] can start to cast doubt on the vaccines," he said.
Already, some provinces are starting to ease restrictions on the fully vaccinated. Manitoba's requirement that anyone entering from outside the province no longer applies to those who received their final vaccine dose at least two weeks prior to their arrival, and officials in Saskatchewan announced on Tuesday that close contacts of COVID-19 patients no longer have to self-isolate if they have been fully vaccinated.
THE AMERICAN EXAMPLE
While it's still not clear when fully vaccinated Canadians will be given recommendations on how they can live their lives, our neighbours south of the border have federal-level guidance on everything from discarding masks to singing in choirs.
The CDC's website includes robust advice on what aspects of normal life Americans can resume two weeks after they have received their final dose of vaccine.
Citing a reduced risk that the fully vaccinated can transmit COVID-19, it recommends that anyone in that situation can more or less resume their pre-pandemic activities.
The CDC recommends that those who have completed the vaccination process no longer have to distance from others, and can limit their face mask use to times when they are using public transportation, in airports or transit stations, and at correctional facilities or homeless shelters.
Dining, exercising, singing, gathering are no longer cause for concern for the fully vaccinated, the CDC says – regardless of how many people are present or how close together they are.
For fully vaccinated travellers, the CDC says, COVID-19 testing upon departure and arrival are no longer necessary. Post-travel quarantine periods are also a thing of the past, at least within the U.S.
However, the CDC cannot overrule state or local governments, which are still able to require masks, distancing and other public health measures despite the federal recommendations.
DON'T RELAX MEASURES YET: WHO GUIDANCE
The World Health Organization (WHO) has its own thoughts on lifting public health restrictions. Its guidance was updated on Tuesday to address vaccination status for the first time.
In the UN organization's view, any community transmission of the virus at all is still enough reason to encourage remote working for as many people as possible, while risk of an overwhelmed health-care system should have authorities looking at virtual classrooms and business closures.
New to the WHO's approach is the possibility of relaxing some measures for those who have been fully vaccinated, as well as those who have tested positive for the virus within the past six months and are no longer infectious.
It recommends that countries follow a "risk-based approach," tailoring restrictions – and whether they apply to the fully vaccinated – to whatever is needed to avoid unduly straining local health-care systems.
"Local authorities may consider allowing congregation of fully vaccinated or recovered individuals without wearing masks and without applying physical distancing in indoor privatesettings in regions with low SARS-CoV-2 incidence," the guidance reads.
The WHO defines low incidence as fewer than 20 active cases per 100,000 population. At the beginning of Wednesday, Canada as a whole had nearly double that rate. Every province from Ontario west was above that rate, as were Yukon and Nunavut, with Quebec hovering just below the threshold.
"I get it that we can't have people throwing off masks right now, but I think we really need to push how good the vaccines are," Chakrabarti said.
"They're our ticket out of here, and we're on the off-ramp right now."