An illustration of a streetscape, with small buildings and houses, and people on the sidewalk. In the sky are giant menacing coronaviruses, with tentacles reaching into windows, and surrounding people.
Illustration by Callum Moscovitch for the Halifax Examiner. All rights reserved. Credit: Illustration by Callum Moscovitch

All remaining COVID-19 restrictions, including isolation, are no longer in place in Nova Scotia as of today. It’s the fifth province to drop the isolation requirement, following on the heels of New Brunswick, Manitoba, Saskatchewan, and Alberta. The three territories also no longer require isolation.

While some people are embracing the change announced on Monday, others are concerned.

To talk about this change, how best to continue protecting yourself, and the ideal time to get your next booster vaccine with another wave expected this fall, the Halifax Examiner spoke to Dr. Scott Halperin. He’s director of the Canadian Center for Vaccinology and a professor of pediatrics and microbiology and immunology at Dalhousie University and infectious disease at the IWK Health Centre.

Here is our conversation, edited for brevity and clarity.

A smiling middle aged man in a pale purple button down shirt smiles at the camera.
Dr. Scott Halperin. Photo: Contributed

Halifax Examiner (HE): Do you have any concerns about this change?

Dr. Scott Halperin (SH): I do. I have concerns. I understand it. Our government is stepping back and saying that when government intervenes, there needs to be a strong reason to intervene and a pressing public need.

I think we should emphasize that those words were carefully selected. It wasn’t just the words “we suggest.” They are strongly encouraging that people still do isolate for a period of time if they have COVID. I guess to me that’s the education component. And does education work? I hope it works.

But the bottom line is that people should be doing that anyway and they should always have been doing it. They should have seen the benefit of having done that when we first did that. Infections went away. We didn’t see a lot of viruses, not just COVID. We didn’t see a whole lot of viruses because when people were sick, rather than spreading it around, they stayed home.

One of the things we have to encourage the population and general public about is that’s your gift to society. When you’re sick, stay home. That’s your gift. You’re not going to infect somebody else who really doesn’t want to get sick. And you probably would have appreciated it if whoever gave you that COVID stayed home. Just because they didn’t doesn’t mean we shouldn’t. It’s all about the social contract that we have with other people.

People are going to die because of this. It’s not as many as at the beginning of the pandemic, but if you’re walking around and you say, ‘Well, I’ve got COVID but I’m feeling okay, so I’m going to go out the next day, this is just the mildest cold, I’m doing great,’ you’re spreading that virus around.

You don’t know who you’re going to come in contact with. You may come in contact with a 70-year-old whose immunity has waned from their last vaccine and they get infected, they end up in ICU, and they die.

HE: So you think there might be more deaths?

SH: You know, we will see a blip up in deaths. It’s not going to overwhelm our health care system, but that’s not the sole goal here. I think that’s really important for people to understand.

HE: I think it’s fair to say many folks are not necessarily trusting of their fellow humans’ ability to abide by that social contract and that’s where a lot of the anxiety comes from?

SH: And it’s understandable anxiety. Before when you had to self-isolate, you couldn’t drive your kids to school if you had COVID. Now you can drive your kids to school or you can drive them and drop them off at their activity and pick them up. But you can still decide that you’re going to not do anything else and not say, ‘Well, while they’re swimming, I’m going to go walk around the shopping mall.’

You can say I’m going to just go home, or I’ll sit in the car and read a book and still have the non-mandatory part, but still protect society. And people can still be a little bit freer because mandatory before meant you are not allowed to go out of the house except to go on a walk. It was fairly strict.

But you can still protect others by not going out when you’re sick. Or if you have to go out, wear a mask when you’re sick. People can take it upon themselves to help the rest of society and try to protect others.

HE: I assume that for those concerned about increased risk, your advice would be for them to continue all of those mitigation measures — wearing a mask when out in public, handwashing, staying two metres apart, all that kind of stuff?

SH: That’s right. These things work. They’re not absolute but they do work. I also hope that they don’t get rid of all those hand sanitizers. I love to walk into a store and see the hand sanitizer there and I hope that never goes away.

Absolutely people can wear their masks. I will certainly have masks in my glove compartment so that if I’m going into stores where it’s crowded and I can’t keep a couple of metres away from people, I’m going to continue to wear a mask.

I think people can protect themselves, but I do strongly encourage people to try to protect others as well. I will be continuing to.

HE: We keep hearing about another pandemic wave in the fall. Should those who are eligible be getting their fourth boosters now, or wait until the fall?

SH: I think it’s a risk assessment. If you’re going to be doing the usual summer things outside where there’s a lot of space and you can take some reasonable precautions, then it’s reasonable to delay your dose. Unless you’re at a higher risk. If you’re at high risk, you should be getting a booster as soon as it’s available.

If on the other hand you’re going to be travelling and spending a lot of time in airports and going to tourist destinations or in big crowds, or you’re planning to go to a lot of concerts or places where there are going to be wall to wall people, you might want to get your booster sooner.

HE: What about an updated vaccine?

SH: We don’t know what the future is going to be. We predict there’s going to be another wave. We also predict that there may be an updated vaccine. Once that updated vaccine is available, it’ll likely be recommended regardless of how many previous doses you have and it will hopefully much better match and that might provide higher protection.

If you’re higher risk, I would get a (booster) vaccine now, because the likelihood is a new vaccine will be available to you first because you’ll be a priority group.

HE: What role do vaccines continue to play as we navigate this pandemic?

SH: Vaccinations are still going to continue to be our best bet of controlling it. People have natural immunity. A lot of people now have hybrid immunity, which means they probably got vaccinated then still got the disease. That natural disease will also boost one’s immunity.

The (new) vaccines will be approved, they’ll be modified to more closely match the variants that are circulating at the time and then that will boost immunity way up to what it was hopefully at the beginning, where it was 95% in that honeymoon period.

If we get those changed vaccines quicker and get more of the population quicker, we may be able to really suppress circulation of the virus. That’s still the hope and that’s still the objective.

There’s still a lot of research work going on to improve the vaccines and testing of them, so I think as long as this virus is circulating and causing severe disease and death, vaccines are going to be our best hope in terms of supplementing natural immunity and not spinning the wheel and hoping for the best.

HE: What would your advice be to those people who are really, really anxious because they’re in one of those risk categories or care for someone in one of those risk categories. What’s your messaging to them when their anxiety is running high?

SH: The vaccines that they’ve received have been very effective. We know that boosters are effective, but they drop down. But the stability against severe disease, hospitalization, intensive care and death are still there.

You can decrease your risk by two-thirds of getting severe disease. That’s still a game winner. So you’ve got some immunity, the vaccines continue to help you, plus the public health measures of distancing, handwashing, masking in high risk times. All of those should help protect you.

HE: Is there anything else that you think would be important to articulate?

SH: People should recognize that recommendations are going to continue to change and even though things are backing off now, if the virus changes, we may have to implement things again. Public health is trying to be as responsive as possible to allow the maximum amount of freedom that’s safe for the current situation. The current situation may change, so people can’t say ‘Oh, you made a mistake.’

If it’s the right decision at this time, it may need to be changed at a later time and those recommendations could be more restrictive or more lenient depending on the current situation.

Summer tends to be a good time in terms of respiratory viruses because we are outside, we are more distanced. But in the fall, when school starts again and we get back into more congregate situations, that has always been a time when viruses start circulating more so we can predict that will happen again.

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Yvette d’Entremont is a bilingual (English/French) journalist and editor who enjoys covering health, science, research, and education.

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