Doctors warn holidays will likely bring COVID-19 infections

Ottawa's wastewater data shows that the COVID-19 signal is 10 times higher than it was last December before Omicron hit, but the biggest difference between this year and last year is how much people care, according to an epidemiologist.

Raywat Deonandan, an epidemiologist and associate professor at the University of Ottawa, says this year people are lacking "the existential dread" of the holidays in 2021.

"There's almost no concern this season. [But] the hospital situation is worse, so there's less room at the inn this time around," Deonandan said.

"I think people should be more careful about behaviours that may require them to seek emergency medical care because that care might not be there if you need it."

Paired with other respiratory illnesses, he says the health-care system is facing a high-pressure holiday season.

A January ripple?

Deonandan said a bump of infection is likely in January because it follows the recent trend of more common, less severe waves of infection. And with people heading indoors, more transmission is likely a given.

"What we seem to be seeing though is the peaks are lower, but the troughs are higher, so there is this oscillating equilibrium," he said.

That levelling out is not a good thing he said, as it means we'll likely be living with high levels of COVID for some time.

Ontario's Chief Medical Officer of Health Dr. Kieran Moore is also predicting an increase in cases in January boosted by the holidays.

Ottawa Public Health reported a rise in COVID-19 infections last week.

Tyson Graber, the co-lead investigator on the OttawaCOVID-19 wastewater projectand an associate scientist at the Children's Hospital of Eastern Ontario Research Institute, agrees with Deonandan that we're seeing "very high levels" of COVID-19, but doesn't anticipate a new wave.

"It's a little bit of a roller-coaster ride," Graber said, notingthere hasn't been a strong uptick in the wastewater in thepast week or two.

Working from those trends, Graber said he doesn't expect a major wave, but just like last year a new variant could upend that prediction.

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Holiday socializing

While Deonandan doesn't suggest "hermitting," he encourages taking steps to limit the spread of respiratory infections, especially before holiday gatherings that might bring you into contact with more vulnerable younger or older family members.

That includes masking in indoor public spaces, hosting in well-ventilated places and getting vaccinated or boosted.

Deonandan says the new boosters are still effective at minimizing transmission for a period of time and that will be important as people are mingling in the next few weeks.

He criticized governmentmessaging which he characterized as live your life normally if you've been vaccinated calling it "lax" and "not necessarily good advice."

Because, he said, it doesn't account for real fears that many in the public have about long COVID and the risk of repeated infection.

He said researchers are looking into the possibility of immune damage from repeated infection.

"That might mean reducing your ability to fight off future infections of a variety of diseases, not just COVID," Deonandan said.

"It strikes me as a responsible thing to do be conservative and avoid infection while scientists figure that out just in case they're right."

More than 10% positivity rate

To back up the high levels seen in Ottawa's wastewater, Graber said, the positivity rate in the city is also high sitting over 10 per cent.

The positivity rate is the proportion of people tested for COVID-19 who test positive.

While the comparison between last year and this year isn't exact last year at this time testing was still open to the general public the people who are tested tend to be a representative sample, Graber said.

"It's a much smaller cohort being tested and it is essentially health-care workers, but the health-care worker cohort positivity is a pretty good predictor of what's happening in the community."

Looking at the "variant soup" that's in Ottawa's wastewater right now, he sees the Omicron subvariant BQ 1.1 taking over, followingglobal trends.

The variant has "high growth potential and is a little more immune evasive than other variants" so he said he expects to see more of it in the coming weeks, but nothing hugely significant aspeople have already begun their holiday visiting without a serious increase in cases.

"Immune protection is still pretty good. Not saying that we won't see any increase, but I don't think we'll see any skyrocketing cases in the next few weeks."