Corona Virus: It's a Marathon, Not a Sprint

[Smoove_B]

Sooo... I have all of those except the last one. The headaches also aren't constant so not a big deal until they hit.
I know that long Covid was tossed around as a possible cause to all myedical issues (the kidney failure and strokes and everything else) bit no way to confirm it.
I have decided to just not believe in Covid anymore. If Disney has taught me anything it's that if you dont believe in something it disappears.
Noble prize here I come!

Have you met with or been evaluated by a Long COVID specialist? I believe all the major hospital systems in our state have special divisions dedicated to it. Not just doctors, but support groups and outreach services. At least, Atlantic Health Care does, hopefully someone near you. Confirming it is hard, but I believe they're using evaluations similar to Lupus (also difficult to diagnose) where if you have [X] number of conditions after an infection, you're in a probable or likely category and if they persist, then you're offically designated with Long Covid.

It reminds me of that scene in Kindergarten Cop where the bad guy is in a pharmacy with his mom and the mom is getting meds for his son and he says something like "you gave me all that crap when I was a kid and I never even got sick" and the mom replies "why do you think you never got sick"
It also reminds me of IT. When you do the job right and nothing ever breaks it makes it look like you aren't needed.

Ooh, that's a good one. Totally forgot about that scene. I'll need to find a copy.

[Max Peck]

[LawBeefaroni]

It reminds me of that scene in Kindergarten Cop where the bad guy is in a pharmacy with his mom and the mom is getting meds for his son and he says something like "you gave me all that crap when I was a kid and I never even got sick" and the mom replies "why do you think you never got sick"
It also reminds me of IT. When you do the job right and nothing ever breaks it makes it look like you aren't needed.

Ooh, that's a good one. Totally forgot about that scene. I'll need to find a copy.

I just got my flu shot. Like 15 minutes ago. We have a new online consent form that I had to sign. When I got to the clinic they gave me a paper version of the exact same form to fill ou lt manually. I was a bit peeved and the nurse said, "Computers are down, again, of course." Guess which team was in line right behind me to get their shots? Yep, IT support.

[Smoove_B]

Another article on what might be coming. In short, no one knows because there are too many variables. Namely, whether or not soaking the population in non-stop infections for the last 10+ months has made any difference as we head into 2023:

In fact, some researchers say the U.S. is already starting to see early signs of that. For example, the levels of virus being detected in wastewater is up in some parts of the country, such in Pennsylvania, Connecticut, Vermont and other parts of Northeast. That could an early-warning sign of what's coming, though overall the virus is declining nationally.

"It's really too early to say something big is happening, but it's something that we're keeping an eye on," says Amy Kirby, national wastewater surveillance program lead at the Centers for Disease Control and Prevention.

But infections and even hospitalizations have started rising in some of the same parts of New England, as well as some other northern areas, such as the Pacific Northwest, according to Dr. David Rubin, the director of the PolicyLab at Children's Hospital of Philadelphia, which tracks the pandemic.

"We're seeing the northern rim of the country beginning to show some evidence of increasing transmission," Rubin says. "The winter resurgence is beginning."

Assuming no dramatically different new variant emerges, it appears highly unlikely this year's surge would get as severe as the last two years in terms of severe disease and deaths.

Bigger picture:

But booster uptake in the U.S. was already sluggish. "Nearly 50% of people who are eligible for a booster have not gotten one," says William Hanage, an associate professor of epidemiology at the Harvard T.H. Chan School of Public Health. "It's wild. It's really crazy."

And the demand for the newest boosters is pretty lethargic so far. Less than 8 million people have gotten one of the new boosters since they became available over the Labor Day weekend even though more than 200 million are eligible.

What's interesting to me is how it looks in my own state. As of now, the total positive cases we're seeing are pretty close to what was happening in October of 2021. However, we're not testing nearly as many people now as we were in October of 2021 and reporting is anemic at this point. I don't know how to resolve what my eyes see (and my ears hear) in comparison to what the state-level data is reporting.

EDIT: And that doesn't even address what the CDC is switching to by only doing weekly reports. Move along. Nothing to see here.

Anyway, I'm headed back into the bunker. See y'all in the Spring.

[Punisher]

Have you met with or been evaluated by a Long COVID specialist? I believe all the major hospital systems in our state have special divisions dedicated to it. Not just doctors, but support groups and outreach services. At least, Atlantic Health Care does, hopefully someone near you. Confirming it is hard, but I believe they're using evaluations similar to Lupus (also difficult to diagnose) where if you have [X] number of conditions after an infection, you're in a probable or likely category and if they persist, then you're offically designated with Long Covid.

Nope. Just my gambit of new docs. Not a Covid specialist of any sort.
At this point what would getting a confirmed Long Covid diag due?
I dont think there is any treatment for Covid other then treating the symptoms which is what they are doing for issues

[Smoove_B]

Nope. Just my gambit of new docs. Not a Covid specialist of any sort. At this point what would getting a confirmed Long Covid diag due?

I'd...strongly recommend you reconsider. Not only for the support but for the official diagnosis that you're suffering from Long Covid (if that's the case). Now that it's a recognized disability under the ADA, you want to make sure you're recognized as such if it applies.

dont think there is any treatment for Covid other then treating the symptoms which is what they are doing for issues

Not entirely true. They are trying different things and if nothing else you'd be helping by contributing data to helping them figure out wtf is going on.

[Punisher]

Interesting. I didnt know it was considered a disability.
Im already on SSDI but that might help for when I have to get reevaluated next year.

[Smoove_B]

I don't think he knows about medium COVID, Pip:

Recently, I’ve begun to think that our worries might be better placed. As the pandemic drags on, data have emerged to clarify the dangers posed by COVID across the weeks, months, and years that follow an infection. Taken together, their implications are surprising. Some people's lives are devastated by long COVID; they’re trapped with perplexing symptoms that seem to persist indefinitely. For the majority of vaccinated people, however, the worst complications will not surface in the early phase of disease, when you’re first feeling feverish and stuffy, nor can the gravest risks be said to be “long term.” Rather, they emerge during the middle phase of post-infection, a stretch that lasts for about 12 weeks after you get sick. This period of time is so menacing, in fact, that it really ought to have its own, familiar name: medium COVID.

Just how much of a threat is medium COVID? The answer has been obscured, to some extent, by sloppy definitions. A lot of studies blend different, dire outcomes into a single giant bucket called “long COVID.” Illnesses arising in as few as four weeks, along with those that show up many months later, have been considered one and the same. The CDC, for instance, suggested in a study out last spring that one in five adults who get the virus will go on to suffer any of 26 medical complications, starting at least one month after infection, and extending up to one year. All of these are called “post-COVID conditions, or long COVID.” A series of influential analyses looking at U.S. veterans described an onslaught of new heart, kidney, and brain diseases (even among the vaccinated) across a similarly broad time span. The studies’ authors refer to these, grouped together, as “long COVID and its myriad complications.”

Study details:

When scientists analyzed Sweden’s national health registry, for example, they found that the chance of developing pulmonary embolism—an often deadly clot in the lungs—was a startling 32 times higher in the first month after testing positive for the virus; after that, it quickly diminished. The clots were only two times more common at 60 days after infection, and the effect was indistinguishable from baseline after three to four months. A post-infection risk of heart attack and stroke was also evident, and declined just as expeditiously. In July, U.K. epidemiologists corroborated the Swedish findings, showing that a heightened rate of cardiovascular disease among COVID patients could be detected up to 12 weeks after they got sick. Then the hazard went away.

Observation:

But if you’re like me, and trying to calibrate your behaviors to meet some personally acceptable level of COVID risk, then it helps to keep in mind the difference between the virus’s medium- and long-term complications. Medium COVID may be time-limited, but it is far from rare—and not always mild. It can mean a month or two of profound fatigue, crushing headaches, and vexing chest pain. It can lead to life-threatening medical complications. It needs recognition, research, and new treatments. For millions of people, medium COVID is as bad as it gets.

Again, we're still learning; this is all still new as the experiment still continues to unfold 2.5+ years later.

[Smoove_B]

More information supporting the early observation that COVID-19 is a vascular disease spread through the airborne route.

https://twitter.com/EricTopol/status/15 ... 0490528768

Inflammation and dysfunction of the lining of blood vessels—the endothelium—is the basis for many of the cardiovascular complications of Covid. A new, solid review here

Link to study

Mounting evidence suggests that SARS-CoV-2 infection leads to multiple instances of endothelial dysfunction, including reduced nitric oxide (NO) bioavailability, oxidative stress, endothelial injury, glycocalyx/barrier disruption, hyperpermeability, inflammation/leukocyte adhesion, senescence, endothelial-to-mesenchymal transition (EndoMT), hypercoagulability, thrombosis and many others. Thus, COVID-19 is deemed as a (micro)vascular and endothelial disease.

[Max Peck]

Another casualty of the pandemic: Our ability to worry about anything else

It's safe to say that the first two years of the pandemic left a lot of people exhausted and emotionally drained. A new study suggests that the exhaustion showed a reduced ability to care about other global problems.

The work relied on surveying all English-language Twitter for tweets related to climate change both before and during the pandemic. The researchers involved found that the number of climate-related tweets dropped roughly in proportion to rising COVID-19 cases and that the remaining tweets tended to be more optimistic than those in pre-pandemic times. Overall, this suggests that the pandemic taxed what some behavioral scientists call our "finite pool of worry."

[YellowKing]

I can't say that's any kind of shocker. I'd imagine if everyone's house was on fire, we'd see a similar drop in the amount of worry over Covid. Obviously people are going to be more concerned with the stuff immediately affecting them before the ones that aren't. Not sure if that's a "finite pool of worry" or just common sense.

[coopasonic]

"Finite pool of worry"... so does that mean "No fucks left to give" is a real thing. It all makes sense now!

[Zaxxon]

"Finite pool of worry"... so does that mean "No fucks left to give" is a real thing. It all makes sense now!

Fuck around and find out exactly how few fucks you give.

[Isgrimnur]

Decision Fatigue

[hitbyambulance]

possibly also a (small?) contributing factor: with increased focus on mental health, maybe more than a few people finally sought - and received - treatment for their panic and anxiety disorders. (i was one of them, and i personally know a few others. i am no longer living a constant existential crisis. well, ok, i still am, but i am able to put it in a more proper perspective now.)

[YellowKing]

I've had one bout with depression in my life, and it came with an obsessive sense of existential dread. The therapist I saw told me something I've never forgotten. Namely that worrying about the meaning of life, the finality of death, and other deep topics was a luxury few in this world could afford. Most people had far more immediate day-to-day concerns of survival to contend with, so having time to contemplate the biggest mysteries of the universe was a blessing, not a curse.

By the same token, it doesn't surprise me that few people can afford the luxury of worrying about climate change to the point they are actively combatting it. It's hard to worry about your house being underwater in 100 years when you have bills to pay now.

[Alefroth]

Or your house is underwater now, literally or figuratively.

[Blackhawk]

I don't worry about COVID. I know what there is to know, and I know what to do about it. Beyond that, my hands are tied. Actively worrying (or even constantly thinking) about it don't achieve anything, so I don't.

That frees up more worry-space for the political situation.

[Smoove_B]

I actually don't worry about COVID-19 either, not like before being vaccinated - at least as far as death is concerned. Instead I feel a larger sense of dread. Like whatever I imagine characters in a Call of Cthulhu roleplaying game feel when they're coming to terms with whatever eldritch horror they're trying to stop.

I'm quite grateful for people in the field (and adjacent) that have been putting words to what I'm experiencing. This piece that was published this moring from Gregg Gonsalves is a perfect example:

Many of those commentators, political figures, even public health experts, who have succeeded in the push for the urgency of their own normal, haven’t been satisfied with their policy victories on the backs of others. No, they are desperate to position themselves as champions for equity, to shut down any notion that, well, they are simply champions for their own class, their own race. They want to declare victory on behalf of those they left behind. The lovefest between White House Chief of Staff Ron Klain, Covid czar Ashish Jha, and The New York Times’ David Leonhardt is a case in point.

And as he quotes from Ed Yong:

There was a time, at the start of the 20th century, when the field of public health was stronger and more ambitious. A mixed group of physicians, scientists, industrialists, and social activists all saw themselves “as part of this giant social-reform effort that was going to transform the health of the nation,” David Rosner, a public-health historian at Columbia University, told me. They were united by a simple yet radical notion: that some people were more susceptible to disease because of social problems. And they worked to address those foundational ills—dilapidated neighborhoods, crowded housing, unsafe working conditions, poor sanitation—with a “moral certainty regarding the need to act.”

I never really thought my chosen profession was my identity, but it's pretty clear now (to me) that they're inseparable. It feels like the older I get and longer I'm involved (albeit to a different degree than I was 20 years ago), the more important it is for me to be proactive and vocal. And yet, that's seemingly the least helpful thing in this current weird moment. Maybe that's the true source of my angst, currently. I don't know. More coffee.

[Smoove_B]

Hey, remember when we used to respond to information like this? Man, those were the days.

COVID-19 positivity rates are back above 20% in parts of Manhattan, as the latest city data indicate the virus is digging in ahead of winter.

The rolling seven-day positivity rate in the Hell's Kitchen area of Manhattan is up to 22.5%, according to city data Wednesday. That is by far the highest rate in New York City, and no other neighborhood is close. Just a day prior, no neighborhood was over 20%.

At the same time, the transmission rate in Manhattan, at 172.7 new cases per every 100,000 people over the last seven days, is up 7% in the last two weeks.

And:

You may not have heard of these two subvariants before -- BQ.1 and BQ.1.1. Both are descendants of omicron, which has proven to be the most vaccine-elusive and infectious COVID variant to date, and both are spreading at rapid rates.

That's especially true in the CDC's New York region, which also includes New Jersey, Puerto Rico and the Virgin Islands. According to the health agency's latest variant report, those subvariants account for 11.6% and 8% (19.6%), respectively, of COVID cases for the week ending Oct. 15, up from 4.1% and 1.9% (6%) in the report two weeks prior.

The CDC estimates those two variants could account for up to 36.6% of New York area cases, which is nearly double the highest-range estimate at the national level.

[Max Peck]

COVID-19 linked to increase in US pregnancy-related deaths

COVID-19 drove a dramatic increase in the number of women who died from pregnancy or childbirth complications in the U.S. last year, a crisis that has disproportionately claimed Black and Hispanic women as victims, according to a government report released Wednesday.

The report lays out grim trends across the country for expectant mothers and their newborn babies.

It finds that pregnancy-related deaths have spiked nearly 80% since 2018, with COVID-19 being a factor in a quarter of the 1,178 deaths reported last year. The percentage of preterm and low birthweight babies also went up last year, after holding steady for years. And more pregnant or postpartum women are reporting symptoms of depression.

“We were already in the middle of a crisis with maternal mortality in our country,” said Karen Tabb Dina, a maternal health researcher at the University of Illinois at Urbana-Champaign. “This really shows that COVID-19 has exacerbated that crisis to rates that we, as a country, are not able to handle.”

The nonpartisan U.S. Government Accountability Office, which authored the report, analyzed pregnancy-related deaths after Congress mandated that it review maternal health outcomes in the 2020 coronavirus relief bill.

GAO report: Maternal Health: Outcomes Worsened and Disparities Persisted During the Pandemic

[Smoove_B]

Hadn't seen that report; horrific.

Maybe political (doing this right before the midterm elections), but it's still important data to note. We can muddle the testing data but they can't obfuscate hospital data.

https://twitter.com/BNOFeed/status/1583267543770230784

U.S. COVID update: Number in hospital rises 3 days in a row, CDC ends daily updates

- New cases: 48,801
- Average: 40,555 (-1,358)
- Reporting today: 20/50
- In hospital: 26,938 (+95)
- In ICU: 3,195 (-42)
- New deaths: 392
- Average: 362 (-47)

Next update: Tomorrow

Not my area of data to follow either, but I've been seeing lot of people chiming in on social media about pediatric beds being filled (not COVID-19 related) but the fact that respiratory illnesses are ripping through kids in October to the degree that it's already overwhelming hospitals in various regions is...odd.

[Zaxxon]

That's very strange, because we watched Dancing With the Stars tonight and the ICU nurse contestant was telling us all how difficult the pandemic was. When it was happening. Two years ago. In the past.

[LordMortis]

Did a big day out today. Kroger, BJs, and Best Buy. Mask wearing was up! It was me and more than a half dozen elderly black women. (I never noticed the demographic trend until it was pointed out to me here. Now I can't unsee it) Also Kroger screwed me on my milk. 1/2 gallons were supposed to be $1.27 and they charged $1.99, screwing me out of $2.16. That's what I get for not reviewing the receipt before I leave, like I normally do. I am no longer surprised by how often I am mischarged for things. In another world, on another day, I'd go back and wait in line for my $2.16 but I've got too much to do today still and I don't want to go out a third time.

[Max Peck]

Locally: Ottawa Public Health says more people should wear masks

Ottawa Public Health (OPH) said in its weekly Thursday check-in that COVID levels are high and the city has its first flu outbreak of the season at a group home.

Experts recommend people get their updated COVID booster vaccine for better protection against current coronavirus variants, getting a flu shot when it's available, staying home when sick and wearing a mask indoors and in crowded outdoor places.

OPH said not enough people are donning masks.

While COVID vaccines and previous infection give some protection, that protection will wane and subvariants continue to emerge. There are also the risks of long COVID.

Hospital leaders continues to emphasize the pressure they're facing as cold and flu season hits during the pandemic.

Meanwhile, the provincial government may have come up with a solution to the lack of long-term care beds:

Ontario quietly changes LTC rules; visitors no longer have to mask in resident rooms

Ontario has quietly changed masking rules for long-term care homes, no longer requiring visitors or caregivers to wear them when alone with a resident in their room.

Long-term care homes are one of the only places where provincial mask mandates remain, after Ontario lifted most such requirements in June.

But the rules were changed as of Friday, though no public announcement was made. Operators were notified and the COVID-19 guidance document for long-term care homes was updated on an Ontario government website, said a spokesperson for Long-Term Care Minister Paul Calandra.

"Our government is protecting our long-term care homes by investing in Infection Prevention and Control (IPAC), hiring and retaining nurses and PSW's, and increasing daily hours of care for residents," Jake Roseman said in a statement.

"Additionally, we are now offering COVID-19 bivalent booster vaccines to long-term care residents, which will add a further layer of protection against the virus."

Several other changes to COVID-19 rules took effect that day. Visitors no longer have to confirm in person or online that they are symptom free, instead homes are now only required to post signage listing COVID-19 symptoms.

A limit of four visitors per resident at a time for indoor visits has been removed, and long-term care homes can now set their own visitor policy. As well, residents are no longer required to be tested for COVID-19 when they return from an absence.

Obviously, when all signs indicate we're starting into the next wave, it's the perfect time to cease the last measures being taken to protect those who are the most vulnerable to COVID.

[Blackhawk]

I have not seen a single mask on any face but my own for a couple of months now, not at a single location.

[Max Peck]

Winter is coming.

Canada is heading into a potentially brutal winter as COVID-19 hospitalizations rise, Omicron continues to rapidly mutate and booster uptake remains stagnant — all at a time when flu season is returning and the health-care system is already under intense pressure.

COVID-related hospitalizations are currently higher than any previous fall in the pandemic, nearly double last October and almost four times more than in 2020.

And new Omicron subvariants that have been shown to better evade immunity and potentially drive new COVID waves are gaining ground, with more than 300 Omicron subvariants being tracked by the World Health Organization worldwide.​​

"All of the subvariants of Omicron are showing increased transmissibility and properties of immune escape," the WHO's COVID-19 technical lead Dr. Maria Van Kerkhove said during a news conference Thursday, adding that subvariants XBB and BQ.1.1 have shown "significant immune evasion."

[stessier]

My daughter complained about a sore throat last Thursday. It wasn't better on Friday and we at home tested her for COVID but got negative. On Saturday it was still there so we took her to urgent care and she was negative for strep and the doctor was pretty sure it was just a cold. She told us to test her Sunday night again for COVID just to be sure. On Sunday the sore throat was gone, but she was congested (just stuffed up, no cough) but another test was still COVID negative. On Monday, we kept her home from school just out of kindness for others (and she was a bit cranky because she was so stuffed up). She was not alone though. 14% of her school was out including 60% of the 8th grade (her class). Today was better - only 45% of the 8th grade was out, but so were 22 staff members.

Fun times.

[Zaxxon]

There definitely seems to be a massive surge of not-COVID right now. Your example is maybe the 8th similar story I've heard, including in my own household, lately.

[Kraken]

Yeah, I know of many people who are down with "a bad cold," including myself. I stopped testing positive on Saturday but still have a cough, stuffy head, and am fatigued by mid-afternoon. I still have one dose of Paxlovid left to take, so hopefully this isn't long covid.

[Smoove_B]

Yes, I'm on that list. It's been ~2 weeks for me now. The first 4 days were misery but since then I've just had "inflamed" sinuses. Feels a bit like allergies. No cough, no fever, no other symptoms. I've tested negative for COVID 4 or 5 times at this point. It's annoying as hell and other than also being a bit more tired, it's getting old.

[YellowKing]

Let me add to the stories. My wife and I have been sick for a week now with non-COVID. Sore throat, congestion, exhaustion. No fever though. Did not feel quite as bad as when I had COVID but pretty damn close.

The schools here are getting eaten alive with it. One local elementary school today had over 230 students absent....out of 514.

[Smoove_B]

Interesting thread trying to theorize on why we're seeing a "plateau" with the cases, using wastewater data. It's happening in my state and apparently in others (like MA) as well.

https://twitter.com/BillHanage/status/1 ... 1920966657

It's a lot to read through (and perhaps not all that interesting) so let me highlight the conclusion:

So a plateau reflects the virus running through susceptible networks one after another, as people move from being really unlikely to get infected if exposed, to more likely, as immunity wanes. But wait! What about variants and immune escape? Doesn't that change everything? No 9/n

...

So that's my 2c on why the plateau. The virus infects who it can, and those are being continually replenished as immunity wanes. Will the plateau continue indefinitely? I don't think so, because of the winter and BQ.1.1 12/n

In short, we've reached a fuzzy "steady state" where there's a constant pool of susceptible people - people that are susceptible for various reasons - keeping us at this new baseline level of illness (which some might call endemic, but I will not). Not surprisingly, seeing what happens during Thanksgiving/Christmas/Holiday season will help fill in the knowledge gaps even more.

[Max Peck]

The last report I saw on local wastewater monitoring mentioned that the levels had plateaued, iirc.

I checked the website for my doctor's office today, and saw this notice. I can't help but wonder whether they had an outbreak of that nasty cold that is totally not COVID-19 that has been going around everywhere lately.

Oct 24 2022 WE HAVE MANY STAFF, RECEPTIONIST AND NURSES, OFF THIS WEEK DUE TO ILLNESS, PLEASE HAVE PATIENCE AND UNDERSTANDING WHEN INTERACTING WITH THE STAFF IN THE OFFICE

[Zaxxon]

I can't help but wonder whether they had an outbreak of that nasty cold that is totally not COVID-19 that has been going around everywhere lately.

I know you're being pithy, but this is definitely a thing.

[Max Peck]

I can't help but wonder whether they had an outbreak of that nasty cold that is totally not COVID-19 that has been going around everywhere lately.

I know you're being pithy, but this is definitely a thing.

Yeah, I know, and the clinic isn't saying anything one way or the other about what is currently decimating their staff. I will note, however, that if they were taking adequate precautions against COVID then they probably wouldn't be getting hammered by whatever else is also circulating. It is, of course, entirely possible that a number of staff were coincidentally infected with something (or multiple different somethings) outside the work environment and it isn't an outbreak in the facility per se.

However I have little faith in how well the OG rapid test kits are holding up with the new Omicron subvariants that are circulating now. Given the degree to which symptoms overlap with a bad cold, I'm fairly confident that some of the bad colds I'm hearing about are COVID infections that produced false negative home test results.

[The Meal]

RSV, unlike COVID-19, is the rare lung-affecting disease where fomites are totally a spreading mechanism. Acceptable COVID protocols may not be sufficient in preventing RSV’s spread.

[Max Peck]

Fair enough (although hand washing is still one of the things we're being told to do to protect against COVID ).

[Blackhawk]

However I have little faith in how well the OG rapid test kits are holding up with the new Omicron subvariants that are circulating now.

Not to mention that a great many of them are probably expired.

[Max Peck]

2 new COVID-19 subvariants are growing twice as fast as BA.5 in Ontario, public health agency says

The former head of Ontario's COVID-19 science advisory table says it is time to bring back mask mandates as Public Health Ontario says the proportion of the new BQ.1 and BQ.1.1 Omicron subvariants in the province is growing twice as quickly as the dominant BA.5 strain.

Dr. Fahad Razak, an internist at St. Michael's Hospital, says in August and September the health system was showing the kind of strain that's normally seen at the peak of a bad flu season and there is very little capacity to respond to increases in COVID-19 rates.

"For anyone who says, 'Let's not do that,' I would ask, 'What is the alternative at this point? How do we keep the system that has so little capacity, how do we get it to continue to run over the winter?"

Public Health Ontario said in a report this week that COVID-19 activity in the province is generally stable, though it has been gradually increasing since early September. While not a lot is known yet about the BQ subvariants, there is a high risk of increased transmissibility, reinfection and lowered vaccine effectiveness, it says.

"A COVID-19 pandemic strategy that relies entirely on immunity from current vaccines and past infection will be limited in its ability to affect transmission," the report said.

"Continuous [whole genome sequencing] surveillance, monitoring of the impacts of implementation/removal of public health measures, and efforts to increase vaccine equity can all help prepare Ontario for the next stages of the COVID-19 pandemic."