Omicron Variant and public health restrictions

Omicron variant is now sweeping the world and many places are bringing in new public health restrictions. Last year I had argued for lockdowns and tougher public health restrictions. This year I believe doing exact same as some are asking is wrong approach. You may ask what changed? And answer is vaccines. Lockdowns are a blunt tool that help delay not stop cases and before vaccines were widely available, it made logical sense to delay until we could get most of our population vaccinated. But now that around 85% of Canadians are vaccinated, it makes little sense to not pivot. I am not suggesting drop all restrictions like Florida has; but I do believe since virus is liking to be here for many years to come, we need to adopt public health restrictions that reduce spread, but also only cause minor inconveniences.

Below are a list of restrictions I support and then ones I oppose

Support:

  • Mandatory indoor masking
  • Vaccine passports and as more get boosters maybe upping requirement to include 3rd dose
  • Free rapid tests widely available
  • Make boosters available to all and shorten timeline to 3 months from current six months
  • Capacity limits for very large events when cases are high but only as temporary measure
  • Fast track foreign health care workers so we can expand ICU capacity
  • As last resort and only last resort, make vaccines mandatory and monthly fines for unvaccinated, but this should be done as absolute last resort.

Oppose

  • Lockdowns/stay at home orders
  • Travel bans (advisories fine, but no bans)
  • Shutting down certain businesses be it restaurants, bars, gyms etc.
  • capacity limits for small businesses beyond standard capacity
  • Visiting other households (limits fine if reasonable)

My reasons for opposition to one’s above is shutting those down is not harmless. If done to buy time until vaccines, it may be a fair trade off, but not if permanent. Reality is this likely won’t be last variant and there is a possibility virus could be with us for years. If it is, we need to prepare for that and realize such restrictions not sustainable if we have to bring them back every six months. Destroying economy, harming mental health to save a few lives is not a reasonable trade off. We live in a messy and imperfect world and that involves making trade offs. Blunt restrictions if short term are fair trade offs as save lives and harm is minimal. But longer it goes on, greater harm of restrictions while benefits less. Also despite new variant, vaccines still very effective in keeping people out of hospital and restrictions are not about preventing cases, but prevent hospitals from being overwhelmed. UK and Denmark who are furthest ahead in Omicron variant are seeing records in cases being smashed, yet hospitalizations, deaths, and ICU use is far below what it was a year ago pre-vaccines. That shows vaccines are working. Many say hospitalizations and deaths lag cases and that is true. But science also shows those who are vaccinated and are infected are far less likely to end up in hospital than those unvaccinated. As such modeling needs to be adjusted and not continuing to use old modeling we used pre-vaccine. Finally even if such restrictions did save more lives, I believe in thinking long term not short term. It may help in this wave, but may long term end up killing more. One of the keys here is public trust of health experts and if public thinks restrictions are too extreme; they will just start ignoring them altogether and that will mean more deaths in future waves. As such restrictions should be reasonable so public will continue to follow guidelines and not give up. Otherwise its about being realistic and while no deaths is ideal, that unfortunately is not possible. But having a few more deaths this wave if more lives saved in future waves is an unfortunate trade off that is worth making as goal should be about saving as many lives long term not just short term. And more importantly, once public loses trust in public health experts, it doesn’t just mean not following guidelines for rest of pandemic; it also means people will ignore them elsewhere. Finally we want people to get vaccinated and get their booster and in order to ensure that, there needs to be some reward for doing so. If it won’t mean some benefit other than just staying alive, incentive to get vaccinated and booster is greatly reduced and that will ultimately make pandemic worse long run. Last thing we need to do is help the anti-vaxxer conspiracy types, yet I worry some are advocating for restrictions that will just play into them. I worry in Canada, we are heading too far in restrictions and I believe whatever short term benefit, it will do more long term harm. Too many are panicking when now is time to make rationale decisions and not panic. Everyone is going to eventually be exposed to COVID-19 so unless you want to stay locked in home forever, there is no getting around that. Main thing is exposure is spread out enough doesn’t overwhelm hospitals. And doing just what I support not oppose may mean things get worse than full lockdown in short term, but wave will also end sooner and many of the harms I fear can be avoided.

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