Montreal doctor says return to post-pandemic normalcy is in sight
A return to post-pandemic normality is in sight, according to microbiologist and head of the Jewish General Hospital's Division of Infectious Diseases, Karl Weiss in Montreal.
Invited by Metropolitan Montreal Chamber of Commerce this week, Weiss gave a rather optimistic assessment of the situation that will now be required to "live with the virus", as the expression has come to be used.
Weiss notes that the gradual lifting of restrictions here and elsewhere has not had a major impact and that it is time to breathe easier.
"We saw what was happening in other provinces, in other countries, that there was no major impact on the functioning of society, so yes, at some point, we had to stop playing the catastrophic and dark scenario by saying that everything was going to fall apart," he said.
It will therefore no longer be appropriate to talk about 'waves' when a possible "COVID 6.0" comes along, as he puts it, but rather an endemic situation like the flu.
However, he points out that the traditional concept of herd immunity no longer applies in the case of COVID.
"The concept of herd immunity for COVID is outdated," he said. "It's not something we should be looking at now, because yes, herd immunity has been achieved. (...) There is a huge proportion of the Quebec population that has had vaccines, that has had COVID, that has had both. We have never in our history had anything where we had so much immunity, except maybe chickenpox.
"In the future, our response to this virus may be much less severe in terms of illness. So we won't get sick. Because we won't be sick, the likelihood is that we'll have less impact on the hospital system, and therefore the impact on the overall system will be much less."
He added that the explosion of cases and hospitalizations caused by the Omicron variant was a game-changer.
"The mortality rate was much lower than in previous waves, so you can see that Omicron has finally made a kind of trade-off: it has become less virulent in exchange for an increase in its transmissibility, which is something you often see with viruses," he said.
Moreover, while catching one of the previous variants did not protect against Omicron, studies show that contracting Omicron does protect against the previous variants.
And the pandemic fire caused by Omicron may have benefits over the emergence of new variants, Weiss said.
"Omicron is such a good recipe for the virus that the virus may not want to change its recipe too much," he said. "Yes, we're going to have sub-variants, yes, we're going to have possible new variants emerging, but the impact on society is not going to be anything like what we had at the very beginning of COVID."
However, he says we should not think of COVID-19 as the new influenza.
"It's not quite a new influenza because it's a more inflammatory virus," he said. "There is the whole syndrome of the long COVID, which is in its early stages and we don't yet know all the outcomes. There is a higher mortality. There's aerosol transmission, so unlike influenza, aerosol means you can transmit the virus over much greater distances, but unlike influenza, we have a lot more vaccines of much better quality than influenza and a lot more drugs coming to market or going to market."
The latest wave has highlighted the need to add more flexibility to the Quebec hospital system, which has fewer beds per capita than almost all developed countries.
Weiss also believes that "a different approach will be needed where we will have to have tests more easily in the workplace."
"Maybe we should create integrated COVID treatment centres off-site, one stop, and putting in place, much like we do in military systems, an early warning system that allows us to see what's going to happen with great flexibility in local application," he said.
"The goal is that we don't want to hospitalize people anymore. We want to hospitalize as few people as possible. We have more and more treatment tools that will allow us to keep patients as outpatients. So it's targeting the people who are most at risk, giving them these drugs as quickly as possible so that these people don't end up in the hospital. If the hospital environment is not overflowing, then there is no reason to close the company."
Weiss warns, however, that the pandemic has caused the system to neglect care, such as surgeries, which will have a social and even economic cost for companies.
For example, he said an employee who couldn't get knee surgery and whose condition worsened may be out longer in the future.
"There's going to be a catch-up phase that's going to be difficult," said Weiss.
-- This report by The Canadian Press was first published March 9, 2022.