As we entered 2022, the theme on everyone's minds was "learning to live with COVID-19," but 12 months later, we can see that cohabitation with a potentially deadly virus is proving to be rather stormy and that the consequences can be severe.
After two years of a relentless fight against multiple waves of infections with public health measures of all kinds, political leaders pleaded for the adoption of a "new normal" by adapting our behaviours to the presence of the SARS CoV-2 virus.
Despite the rapid spread of the Omicron variant and the sub-variants that followed, public health lifted public health restrictions at the end of January. The end of the face mask mandate in public places came in the spring.
In reaction, several experts have regularly called for caution, fearing that the population will interpret this "new normal" as a simple return to life as it was before. In fact, the use of masks has been largely ignored and the fall's triple epidemic (COVID-19, influenza, respiratory syncytial virus) suggests that many people continue to engage in risky behaviours when they experience flu-like symptoms.
Data compiled by the Quebec public health institute (INSPQ) confirmed that "living with the virus" results in greater exposure to risk and many more infections.
As of Dec. 18, there have been 633,802 confirmed infections in 2022, almost equivalent to the first two years of the pandemic combined (641,777 cases). This number is all the more spectacular given that access to screening tests has been restricted since the beginning of the year.
Consistently, the number of hospitalizations related to COVID-19 has also jumped. As of Dec. 18, there were 49,590 new admissions, more than in the first two years of the health crisis (30,043 admissions).
Then, as the number of hospitalized patients increased, so did the number of deaths. As of Dec. 18, 5,688 Quebecers have died from COVID-19 in 2022, up from 2021.
FORGOTTEN LESSONS
In the eyes of Benoît Mâsse, professor of social and preventive medicine at the Université de Montréal's School of Public Health, there are clearly "things we haven't learned." He is concerned about the reaction time of the authorities to the increase in influenza cases this fall, when we should have developed better reflexes after two years of a pandemic.
"If there's one thing we should have learned, it's that we shouldn't wait until the emergency rooms are full to act," he said.
On an individual level, Quebecers must also adapt their behaviour to make cohabitation work.
"Each of us is responsible for reducing community transmission," the virologist said. "If you have symptoms, you should stay home, if you have the slightest doubt that you are contagious, you should isolate yourself."
Wearing a mask must also be part of the equation and become a common gesture in public places when someone has symptoms or doubts.
"These are not reflexes that we used to have, but that's what living with the virus is all about," he said, adding that changes in societal behaviour take time.
Campaigns over the past decades have discouraged smoking, drinking and driving, and supported the use of seat belts. Each time, progress has been observed over long periods of time.
LIVING WITH THE CONSEQUENCES
The adaptation of daily life is not the only drawback of the "new normal," according to Mâsse. "Living with the virus also means living with the consequences. And one of the serious consequences is an epidemic of chronic disease within the viral pandemic."
A growing number of health experts and political leaders are concerned about the chronic form of COVID-19, commonly referred to as long COVID.
In an overview of the upcoming report of the Post-COVID-19 Task Force on Dec. 14, Canada's Chief Science Advisor revealed that 1.4 million Canadians have reported symptoms of long-COVID to date.
Dr. Mona Nemer confirmed that more and more people are reporting muscle aches, shortness of breath, extreme fatigue, brain fog, gastrointestinal distress or heart palpitations more than a month after contracting SARS CoV-2.
While the mechanisms that lead to the development of long COVID are still unknown, it is known that women are twice as likely as men to develop it and that the condition is life-altering.
"People have reported feeling trapped in their bodies, isolated and misunderstood by those around them. Many had difficulty obtaining care or services. The majority have lost their jobs because of this disability," Dr. Nemer said at a news conference.
Citing U.S. estimates, she said that 10 million people with long COVID would cost society an estimated US$3.7 trillion in lost quality of life, lost income and burden on the health-care system.
In a recent study published in the Journal of the Association of Medical Microbiology and Infectious Disease Canada (JAMMI), Dr. Alain Piché and colleagues from the Université de Sherbrooke demonstrated a high prevalence of long COVID in people infected with Omicron sub-variants.
They observed that 47.2 per cent of the participants in their study were still experiencing symptoms more than one month after testing positive for COVID-19 — an alarming statistic as the new BQ.1 and BQ.1.1 Omicron sub-variants have taken over as the most virulent strain.
The year 2023 could therefore be a variation on the same theme, as we learn to live with the long COVID.
This report by The Canadian Press was first published in French on Dec. 28, 2022.
-This report has been produced with the financial assistance of the Canadian Medical Association. It has no say in editorial choices.
