Front Burner - Schools move online as parents, Omicron rage

Episode Date: January 4, 2022

The Omicron variant of COVID-19 appears to be less severe than previous variants. But it's wildly contagious, so many more people are getting it, meaning hospitalizations are going up. It was in this context on Monday that Ontario Premier Doug Ford announced a series of new measures, including shutting down indoor dining, cinemas and gyms. Social gatherings will be limited to five people indoors and 10 outside. Ontario schools are also moving online until at least Jan. 17. Quebec had already announced a similar measure. Today, host of CBC's White Coat, Black Art and The Dose, and emergency room physician Dr. Brian Goldman on Omicron, school closures and what such restrictions might actually accomplish.

In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. This is a CBC Podcast. Hi, I'm Jamie Poisson. So in broad strokes, what experts were predicting about Omicron has largely come true. It does appear to be less severe than previous coronavirus variants. And it is also wildly contagious, which is a problem because even if

the percentage of severe cases is lower for Omicron, the simple math of so many people being infected so quickly means that we're still winding up with a lot of people in hospital. According to CBC's COVID tracker, hospitalizations have shot up by 57% just in the past week in Canada, and the number of ICU beds filled also rose by 13%. It was in this context yesterday Ontario announced a series of new measures, including shutting down indoor dining, cinemas and gyms, social gatherings limited to five people indoors and 10 outside. And the big one, which we are really going to zoom in on today, moving school online until at least January 17th. Quebec has already done the same and other provinces have extended their winter breaks because of COVID. Today, Dr. Brian

Goldman, the host of CBC's White Coat Black Art and the podcast The Dose and an emergency room doctor here in Toronto on Omicron school closures and what these measures will actually accomplish. Hi, Dr. Goldman. Thank you so much for making the time to speak with us today. I know that you spent most of your holiday working in the ER and this is like your only day off in such a long time. So thank you so much for talking to us. Well, it's nice to talk to you too, Jamie. So I want to start with a general question in light of the Ontario government bringing in a bunch of new restrictions on Monday. And I mentioned some of these in the intro. Premier Doug Ford said the purpose of these measures was

to slow the spread, to blunt it. Based on the current trends, our public health experts tell us we could see hundreds of thousands of cases every single day. If we don't do everything possible to get this variant under control, the results could be catastrophic. Do you think these measures will actually achieve that? Yes, I do. I'm going to remain optimistic here. I think that they will slow down the spread of a rapidly spreading strain of COVID known as Omicron. And one of the reasons why I'm optimistic is that if you look at the sharp incline if this is a straight up vertical curve, it's just shooting for the stratosphere right now. And when we have that kind of of an increase in covid, then I think we can hope that with some shock therapy to the system, we might actually get a rapid decline in in the number of cases.

So so I'm going to I'm going to be optimistic that that two weeks is going to make a difference at this decline in the number of cases. So I'm going to be optimistic that two weeks is going to make a difference at this point in the cycle. Do you wish that measures had been taken earlier? Because I guess this rapid acceleration wasn't exactly a surprise, right? We saw it in other countries in the UK and in South Africa. It's estimated 1.7 million people in the UK had COVID-19 last week, forcing many to pare back holiday celebrations. Joe Pachla is the Minister of Health for South Africa. The number of cases in the fourth wave have exceeded the peaks of the third, the second and the first waves.

Yeah, we saw it in other countries. The projections here from the science table in the province of Ontario said that this was going to happen. And and, you know, the fact that this period of time happens to abut directly against a holiday would have made it the perfect time to just say, look, let's do it. On the other hand, the government didn't allow kids to return to school and start mixing and potentially exposing themselves and exposing teachers to Omicron at a time when maybe there was inadequate infrastructure, inadequate HEPA filters and N95 masks. So that's good.

So the fact is they didn't return to school and that means that they've accomplished what they could have accomplished had they simply said that the holiday will be extended. We need to prioritize the continued health and safety of our kids and our school staff. As a result, we'll be delaying the return to in-class learning for the next two weeks

and continue with virtual learning for the duration of the time away. I know this isn't the news. I want to home in on schools now because you mentioned the Ontario government is saying that students will go online until at least the 17th. Also Alberta and BC have extended their winter breaks until January 10th, although worth noting in BC kids of essential workers can go back now. I know for a while there was a lot of confusion about this, but do we know now whether schools are actually a major source of spread or is Omicron just a complete game changer? I don't think we know enough at this time. I think that Omicron is a game changer.

Also, I think you have to take into account the fact that, especially with younger kids, they are not fully vaccinated or five years and under, they are unvaccinated. Let's take into account the fact that when you've got younger kids, they may not be able to wear masks. They may not be mask compliant at all times. If you don't have proper infrastructure in schools with HEPA filters installed, if you're not equipping teachers to deal with the fact that Omicron is airborne, then you've got a greater risk of spread of the infection. But Jamie, I think the other important point is not just the susceptibility of children, which of course is very important, but it's also the susceptibility of teachers. And I think it was highly likely that had the schools not been closed, for example,

in the province of Ontario, you would have seen high rates of absenteeism among teachers as they acquired the Omicron infection. Yeah, I heard the Ontario's chief medical officer say today that he expects 20 to 30 percent absenteeism due to COVID in all sectors. At any given time in the coming weeks, we can expect across all sectors 20 to 30 percent absenteeism as a result of Omicron spreading so rapidly across Ontario. So our health system has to- Pretty high number, but just imagine a school with 30% less teachers in it, right? I know there are a ton of questions about how severely Omicron affects children. And do we have any more clarity on that at this point?

No, we don't have a lot more information about that at the present time. In general, you know, unvaccinated children will not be affected as profoundly as unvaccinated adults. But when you have a large denominator effect, when you have many, many thousands of kids potentially being infected, then if even a small percentage of them end up requiring hospitalization, it's going to be a large number. And it's a number that will potentially swamp the healthcare system. Right. A small percentage of a very large number is still a large number. Can you tell me a bit more about what's happening in the hospitals right now? I know you've been in them. Like what is the picture right now? So it depends on where you work.

The Omicron wave is arriving at hospitals. I'm working in the hospital. I'm going in every day. I can see that it's a problem, to be quite honest. I see that our beds are filling up. We lack the capacity to care for the patients. And if someone isn't very sick with their COVID, if they're admitted for another reason and they're COVID positive, it's still a much bigger burden of care on the health care system than if they didn't have COVID at all.

You know, I would I would say that over the holidays, the vast majority of the patients I saw were young men and women in their in their 20s and 30s who had congregated together at bars and clubs before they were closed down. But they weren't particularly sick. They had symptoms like scratchy throat, sore throat, cough, dry cough. They felt fluish, maybe a bit lethargic, a bit of a fever, but almost none of them needed to be admitted to hospital. That doesn't mean that absolutely none of them are hospitalized. I saw somebody just yesterday in a COVID assessment clinic who I recommended go to the emergency department because they were huffing and puffing. You could see that they were working hard to breathe. And that meant that they could potentially have a heavy dose of Omicron in their lower respiratory passages, meaning that they were at risk of requiring ventilation at some point.

I hope that didn't happen. requiring ventilation at some point. I hope that didn't happen. The people who require are requiring ventilation, I guess the sickest people in the ICUs, are they vaccinated or unvaccinated? Well, the majority of them are unvaccinated. And you know, we still have significant numbers of Canadians who haven't been fully vaccinated, not as much as the United States, but we're still seeing it. And so they're at the greatest risk. And we're talking about people as well who have, you know, asthma, chronic obstructive lung disease, heart disease, and other major, you know, medical illnesses that are coincident with getting an Omicron infection.

And we're also seeing breakthrough infections. And unfortunately, you know, I certainly saw one person who had been vaccinated twice, hadn't had a third dose, and that person was working very hard to breathe. And that person was almost certainly going to need to be admitted to hospital. So you can't ignore the possibility that we can see breakthrough infections. And if you look at a country like Israel, they're already planning on a fourth dose. They were the first country to administer third doses, and they're can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization,

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to blend the peak, why would that change in two weeks? So what can happen in the meantime? Well, one thing that can happen in the meantime is that many, many more Canadians can receive a third dose of their vaccine. And I can tell you that I'm a vaccinator and those clinics are working full tilt seven days a week. And as fast as we can receive doses, we're administering them if people want them. And I can tell you that the clinics that I've worked at have been full to capacity. And we vaccinated everybody who wanted to be vaccinated. And if we'd had more doses at the end of the day, there might have been people in the line who would have been able to receive them.

So that's one of the most important things that we can do. We had a couple of slow days at Christmas, but we're world class when it comes to vaccine rollouts. We'll be hitting up to our goal is 300,000 a day. The other thing that I think we need to keep in mind is that what we want to be able to do is slow the pace of new infections to spread out the number of healthcare workers, for instance, who are going to get infected with Omicron. Because if all of a sudden, 50% of the healthcare workers who work in hospitals became infected, then there's a risk that there wouldn't be enough nurses to work in ICUs and to work in the emergency department. You know, we've certainly seen that at emergency departments in downtown areas and in rural

areas, in rural parts of Ontario and other provinces. Emergency departments have had to close 12 hours a day. In some cases, they've closed over long weekends, over the holidays, over short periods of the holidays because there weren't enough nurses to work. If you have that in the intensive care unit, it's a disaster. And if you have that in an emergency department where they are one or two nurses away from having to close down, it's a disaster. So by slowing down the rate at which society gets infected, you're slowing down the rate at which healthcare workers get infected,

and you are increasing the likelihood that you will be able to limp along and maintain an adequate supply of health care workers to keep the system running. That's all they're trying to do. So I guess and I don't want to sound like a broken record, but I guess if I'm a parent, I guess maybe I'm thinking that like my kids probably not going to go back in two weeks because I just don't see how how we avoid those bad case scenarios you just talked about there because this thing is just so contagious.

Yes. Well, it is that contagious. So what you're looking for is an improvement in the lag indicators. That means the number of admissions because we really don't know from the number of admissions, because we really don't know from the number of tests now, although, you know, we can guess that as the percentage of positive swabs, PCR swabs goes up, you know, well over 30%, and some say it's going to get as high as 50%, then we know just how widespread the infection is, or we can infer how widespread the infection is. But I think a better indicator for us are the lag indicators, meaning hospital admissions and ICU admissions, and we know they're going up. So you're quite right. Because those indicators, hospital admissions and ICU admissions, tend to lag

about three weeks behind the infection rate, then you won't probably know for another week after the two-week period. So it might make more sense to have a three-week period to be certain that those lag indicators are on the way down. And so, you know, I think you're right. And it's by no means certain that schools will open, physical classrooms will be open within two weeks. We'll just have to wait and see. We know today that the Canadian Pediatric Society tweeted out saying new data from Ontario shows high electronic learning time is associated with higher levels of symptoms of depression and anxiety in children and youth. So how concerned are you? You know, at some point, do you think we need to start talking more about what all of this

disruption is doing to children? So for example, you hear experts talking about the rise in eating disorders, a widening gap between kids with parents who can pay for tutors, et cetera, and those who can't. And if you think that we do need to start having that conversation more, like at what point, when is that point? Jamie, that point was two years ago. And it's still a critical point now. People, you know, kids are suffering and they are, they're a silent group. They will show you how much they're suffering. They won't tell you how much they're suffering. And yes, we're seeing it. We've talked about it on White Coat Black Art, you know, kids with eating disorders as a direct result of of covid anxiety disorders. are especially suffering during during covid and it's well past time and you know if we care about our children and and you know i'm sure there are people right now who are screaming at me saying if

you care about children then open up schools yeah and and i can't argue with that i can't argue with the sense of that i think it's right this is a pandemic so going to the grocery store isn't really safe going to the pharmacy isn't really safe. But we do those things because they're necessary. And school is necessary too. When you have both parents working from home trying to manage two young kids, I think both situations fail. You don't do very well at your work and you don't do very well with your kids. No one wants online learning, but we just want safe schools. And it's just very frustrating that it hasn't clicked into the government that this is what is needed to actually make them safe. And also probably worth noting here, disproportionate impact on parents who work on the front lines, right?

Like you don't have the option to be home or even work from home. This is, I can't imagine how difficult this must uh be for them absolutely yeah i agree i don't want this to come out the the wrong way i i get why we can't just, you know, as we talked about, let this thing rip. But given the spread of Omicron and its apparent lower severity, I wonder if what we also need to do here or if the way that you're thinking about this is changing, like, could we now think about it as large numbers of less severe cases actually helping us get out of the pandemic? Yeah. So you're asking the herd immunity question. Are we inching towards herd immunity?

And as I've said, I started by saying I'm an optimist. I'm still an optimist. And I think that we are. I think that the more people who are infected, the more people who are vaccinated, and I think primarily people should get vaccinated as a way to acquire immunity, the more we are inching closer to the day when COVID of one variant or another will be will be endemic. I'm an optimist, but I'm not a virologist. And from what I have seen and read and heard from virologists and infectious disease specialists, they say we've seen nothing like SARS-CoV-2 in the history of pandemics in its ability to reinvent itself and find new ways of outsmarting

our immune system, our respiratory passages, the treatments that we have. And so I think we have to remain vigilant. But in general, I'm hoping that the general level of immunity will increase over the next few months. And that, you know, it was suggested, you know, by somebody, you know, by some thinkers a lot smarter than I see. You see David Naylor co-wrote an opinion piece saying that this could be the last gasp. You know, I'm paraphrasing here. Yeah, like it just sort of peters out from here. And let's hope that it is, that it does, and that we'll all have a much better middle of 2022 than it's starting out to here. And let's hope that it is that it does. And that we'll all have a much better middle of 2022 than the than it's starting out to be. But I don't know. And I'm not the expert on that. Yes. And I guess we have sort of been in this conversation before, albeit with different

tools, right? Like, like vaccines. Oh, absolutely. And yeah, that's the reason to be the most optimistic we have. We started off with lack of PPE and now we have more than adequate PPE. You know, we have rapid tests. We have we have PCR testing. We have vaccines. We have medications that that could be game changers. So we have lots of reasons to to, you know, lots of weapons to fight to fight Omicron or whatever comes next. And lots of reasons to be optimistic.

OK, thank you so much for this, Dr. Goldman, as always. And I should mention you're doing a show soon where people can get their questions answered on what to do if they have COVID. So when is that? That's going to be this week. And our question is basically going to be, I think I've got COVID, now what? And there are lots of people wondering, you know, what the heck? How many days should I isolate? Is it safe for me to return to work? Do I have to prove that I'm negative, that I test negative to be able to return to work? And, you know, if everybody seems to have the same illness in my family,

can we assume that I've got COVID? Questions like that. Oh, very good question. I will definitely be tuning in. So thank you. Thank you. My pleasure. All right, that is all for today. I'm Jamie Poisson, and we, go to cbc.ca slash podcasts.