Remarks from the Chief Public Health Officer, March 10, 2023

Remarks from the Chief Public Health Officer on COVID-19 and other respiratory viruses, March 10, 2023

March 10, 2023 | Ottawa, ON | Public Health Agency of Canada 

Tomorrow marks 3 years since the WHO Director General first characterised COVID-19 as a pandemic. Reflecting back on these years, we are reminded of the challenges and sacrifices we've endured, including grieving so many lives lost due to and during COVID-19 under difficult circumstances. With a view forward, we are now taking stock of where we are today, including assessing the patterns and ongoing impact of COVID-19 on our population and health systems.

The many actions we took together had an important impact in slowing spread and reducing severe outcomes of COVID-19. Modelling data has indicated that Canada's experience with COVID-19 could have been much worse. However, COVID-19 has still had an enormous impact over the past 3 years. Since January 2020, when the first cases were reported in Canada, we have experienced multiple waves of COVID-19 - resulting in millions of cases leading to over 51 thousand deaths to date. The scale and duration of this unprecedented health event catalyzed a whole-of-society response that has tested the resilience and fortitude of each of us.

We are now at the point in Canada where COVID-19 activity has reached a relatively steady state. In recent months there have been no distinct variant-driven waves - such as the well-defined Alpha, Delta and initial Omicron waves seen previously. Likewise, over the past 6-8 months, COVID-19 hospitalizations have been relatively stable despite the ongoing spread of Omicron subvariants. ICU admissions and deaths have also stabilized.

Population immunity, estimated using regular antibody studies, is currently high and relatively stable. This level of immunity is also approaching a steady-state, due to the combined effect of our overall high vaccine uptake and infection-acquired immunity. However, as population immunity levels fluctuate, disease activity may also vary.

While uncertainty remains about the seasonal patterns for COVID-19, the current trend suggests we may not see any major waves in the coming months as we prepare for a potential fall and winter surge. Together with international partners we will also continue to monitor the situation closely – and specifically watch for the emergence of significantly immune evasive strains.

A steady state does not mean that COVID-19 won't have serious immediate and lingering impacts. COVID-19 hospitalizations remain at relatively steady levels but continue to have a significant impact on our health care systems. Likewise, there is a continued disproportionate impact on older and immunocompromised populations. We also know that COVID-19 infection can affect chronic disease rates, and that post COVID-19 condition – or PCC also known as long COVID – is also a significant public health challenge, as underscored by Dr. Nemer's recently published PCC taskforce report. To address these challenges, it will be important to be vigilant and employ prudent, risk-based, use of prevention measures as we continue to learn about longer-term impacts, and optimal vaccine strategies and treatments.

The Public Health Agency of Canada's work to support clinical practice guidelines on PCC, and the Canadian Institutes of Health Research's new funding to establish a pan-Canadian Post COVID-19 Condition research network, exemplify some of the tangible steps being taken towards improved management and mitigation of COVID-19's longer term impacts.

Going forward, we expect ongoing circulation of the SARS CoV-2 virus but with the availability of effective preventive measures and treatments we will be able to manage COVID-19 in a more sustainable manner.

On March 3^rd the National Advisory Committee on Immunization (NACI) released COVID-19 booster recommendations for the upcoming spring.  NACI recommends that an additional booster dose may be offered, 6 or more months after the last vaccination or infection, to adults at increased risk of severe illness from COVID-19. These include:

• people aged 80 years or older,
• adults 65 to 79 year of age, particularly if they do not have a known prior history of SARS-CoV-2 infection,
• adult residents of long-term care homes and other congregate living settings for seniors or those with complex medical care needs, and
• those aged 18 years and older considered to be immunocompromised.

NACI recommends the use of bivalent vaccines for booster doses. Regardless of risk factors, we encourage anyone who has not yet received their primary COVID-19 series or their fall 2022 booster doses to get these vaccinations.

As we adjust our collective response and move towards the management of COVID-19 as a regularly occurring disease, planning for the Fall must take into account the potential demands of COVID-19 and other respiratory infections on our healthcare systems. If we build on the capacity and knowledge gained in the past years in protecting ourselves, our health workforce and each other, we will be well prepared to adapt our response to future needs.

Read my backgrounder to access COVID-19 Information and Resources, including information on vaccination and ways to reduce your risk of infection and spreading the virus to others.

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