Awaiting COVID Endemicity

 "[How serious the waves are will depend partly on whether they are fuelled by Omicron variants or a new variant that is] fully disruptive."

"They [people with three vaccinations or infections] have fifty times less risk of ending up in the hospital, of ending up in the ICU. We have so much immunity compared to the beginning [of the pandemic]. It's just worlds apart."

"There are a lot of infections out there, but luckily people struggle less with it."

"The reason I still wear a mask is because, first of all, I still don't want to contribute to the chain of transmission, because there are vulnerable people out there."

"And we don't know enough yet about the risk of long COVID. It's safe to assume that it's reduced with vaccination, but, for somebody like me, should I risk getting brain fog?"

"Some things as simple as a mask, that I can wear relatively flexibly when I go inside ... Why would I not do that if I know what we know about the amount of infection [in the community]?"

Dr.Peter Jini, former scientific director, Ontario COVID-19 science advisory table

Dr. Peter Juni, the former scientific director of the Ontario Covid-19 Science Advisory Table, speaks to an audience in Ottawa on Thursday. Photo by Tony Caldwell /Postmedia

According to experts addressing the issue of the SARS-CoV-2 pandemic addressing a Swiss-embassy-sponsored symposium on COVID, attended by those working in the science policy field, waves of COVID-19 will continue to emerge in Ontario every three to four months. A year may pass, even longer, before the virus reaches the stage of endemicity, such as occurs with the seasonal flu.

The waves themselves may change and become lighter in impact, infecting fewer people, and with less serious illness. Mostly because the population has been so well vaccinated its preparation to withstand such waves has improved enormously. No one, however, states anything relating to this virus with great certainty. What is fairly well assured is the wall of immunity that has been built through inoculation and widespread infection.

Those circumstances alone give a kind of guarantee of how serious the waves may be -- entirely setting aside the potential of new mutations emerging with qualities that may change infectability and disease outcomes. Yet, as Dr. Juni emphasized, those who have had three vaccinations or infections become much less likely to fall seriously ill or to die from COVID-19.

According to his estimation, 20,000 to 25,000 new infections of COVID-19 are diagnosed in Ontario each day; higher than what occurred at most times since the pandemic began in early 2020. "There are a lot of infections out there, but luckily people struggle less with it." Even so, hospitals in the province have found themselves barely able to cope, with insufficient health workers, when they are well over capacity to absorb new cases.

Another item mentioned by Dr.Juni was that fully 70 percent of people in Ontario contracting the virus have no detectable symptoms. He feels that several years may be required before COVID waves recede to an endemic state where a baseline level is reached with infections. Since the pandemic began, the proportion of people infected with COVID and who die has dropped to the point where the rate is similar to the ratio for influenza.

CHEO Emergency Department