The Decibel - Why it feels like everyone is getting sick right now

Episode Date: January 12, 2024

There seems to be a lot of illness going around right now. Hospitals are struggling with what the Canadian Medical Association called an “avalanche of patients,” and many of you have questions.Today, The Globe’s health reporter Carly Weeks joins us to explain how this year’s respiratory virus season is shaping up, and she answers your questions about COVID, RSV, the flu, and more.Questions? Comments? Ideas? Email us at [e-mail]

I don't know about you, but I know a lot of people who have been getting sick recently, including myself. It's been a tough season when it comes to respiratory viruses, COVID, RSV and the flu. And you guys have questions. So today I'm talking to the Globe's health reporter, Carly Weeks. She'll explain what we're seeing so far this virus season, and she'll answer your questions. I'm Mainika Raman-Wilms, and this is The Decibel from The Globe and Mail. Carly, thanks so much for being here.

Of course. It really feels like there is a lot of illness going around right now. So I guess, like, what is going on? How would you describe this virus season that we're having? Yeah, I mean, we're right in the thick of it in respiratory virus season. You know, we do see this every year. I think what's really different is that for the past few years, it's really been unusual. I don't have to remind people that we've just been through a pandemic. And, you know, according to who you ask, we're kind of still going through it. And that's because, you know, COVID is not yet at a predictable enough place to really say that it's sort of a seasonal virus like the flu.

And so that can complicate things. So, you know, the past few years have been a bit unusual. There was a few really quiet years when a lot of people were at home masking. Things were closed down because COVID was top of mind. So flu numbers were down. Last year, we saw numbers come back in a huge way. This year, there's a lot of regions in the country that have had a really hard time or are having a hard time currently. And so I think that no matter where you look, there's pockets of the country that are really seeing so many patients coming in, a lot of sick people.

Healthcare systems seriously under strain. But at the same time, the overall numbers themselves don't look as though they're sort of beyond the scope of what you might see in a, say, a very bad flu year. I mean, not to sort of say the numbers aren't there, they're there. But I think what the important context is that our healthcare system is already at or over capacity. So just adding any sort of regular flu season on top of that, let alone a bad one, is going to have a great impact. And you mentioned that it's worse in some pockets of the country. Can we just quickly hit on like, where are we seeing this the worst? If you look across the

country, there's various regions that are seeing different things. So, you know, a few weeks ago, I was speaking to officials in Alberta and clinicians. They were getting absolutely hammered by the flu. They were seeing lots of people getting admitted, including children. And, you know, whereas in Ontario, they were seeing higher numbers of RSV. Now, this week, we're hearing from BC health officials that they're basically in a state of crisis because of flu numbers and other respiratory viruses going around. So basically, as sort of one region, things kind of peak and start to decline. Another region is seeing a huge increase. That's just how viruses spread, right? It's not going to be all at once. But I think what that does say is that this is likely a warning to the rest of the

country. You know, if you haven't seen really bad numbers or if you're in a province where, you know, the cases aren't yet really at their peak, they likely will start to peak. And so that's something that people need to keep in mind. Quebec is another province to mention that they've seen really, really high numbers in a healthcare system that is barely functioning. You know, it's been a very difficult period, and we're certainly not out of it yet. Yeah. Okay. So Carly, you mentioned COVID, of course, RSV, flu. And we have a bunch of questions from the audience here. So we're going to start with one that is actually about these three viruses.

So can we just, I guess, break down the difference really between RSV, COVID, and flu? And how would you know if you have one versus the other? Yeah, that's a great question. The first one is easy to answer. The second one, not so easy. So they're all respiratory viruses. So essentially, these are common viruses that get spread around, it enters likely through upper respiratory tract when someone coughs or sneezes nearby. The difference between them can be a

little bit hard to distinguish. So let's take something like the flu. The flu tends to be more severe than a common cold. So back in the innocent days severe than, you know, a common cold. So, you know, back in the innocent days before COVID, you often wondered, is it a cold? Is it the flu? You could typically tell if it's the flu based on just how severe, how severely impacted you are. So if you're, you know, you have a high fever, you're totally aching, lots of fatigue, you know, the symptoms are more extreme. And that's often why we pay more attention to the flu, as opposed to, you know, common cold viruses, which tend to be milder. RSV is another very common virus that essentially everyone gets by the time they're age two, and then you can get reinfected with it.

For most people, it basically is a common cold, you know, coughing, sneezing, that kind of thing. Imagine those kinds of symptoms. But it can be very serious for young children, particularly those two and under, especially six months and younger or older adults. Those tend to be the highest risk groups when we think about any kinds of, you know, colds or viruses. COVID is, again, a bit of a different beast. And I say this because it's continuously shifting

and it's not yet very predictable. So the symptoms can look like, you know, a common cold in some people, you know, there's still things like, you know, the loss of sense of taste and smell. But, you know, largely what we're hearing from a lot of people now is that the symptoms may not look the same person to person. It's a very tricky thing to sort of tell. And so unless you're sort of in an emergency room and a doctor's ordering a panel of tests, you may not know what you have. And so the common sense guidance is essentially, you know, stay home when you're sick, try not to infect others.

And this is why we also need things like stay at home legislation so people who don't have sick days can take them. OK, so it sounds like, yeah, there's the symptoms are kind of overlapping, different from person to person. So that's why it's kind of hard to tell always what you actually have. Carly, you also mentioned the common cold. And I feel like that's something we talk about a lot. But what exactly is just a common cold? Yeah, there's a whole ton. There's like hundreds of different cold viruses that can go around.

Enteroviruses, rhinoviruses, all of these viruses belong to these families. It's sort of like trying to find a needle in a haystack. There's so many of them going around. And because they're not such a heightened risk to, you know, people's health, they don't tend to get the same level of attention or public health concern. And, you know, probably nor should they. I mean, flu is very serious. It leads to deaths in children and adults every year. And so, you know, we tend to focus a lot of our public attention there. And even then, you know, we tend to focus a lot of our public attention there. And even then, you know, we seem to struggle to get enough attention on those deadly viruses.

So before the pandemic, of course, we still did have a winter respiratory virus season. I guess now that COVID is in the mix as well, are more people overall just getting sick, Carly? Like, are we seeing overall higher numbers of illness? That's a really great question. I think it's hard to say without a really deep, well-researched study exactly what's going on in terms of, you know, are we seeing more people getting sick more often? I think it is fair to say that we have been through a very unusual period, and we're not necessarily out of it yet. So when you do have an extra virus added into the mix, it has certainly had a big impact. So according to the most recent federal data, there's nearly 5,000 patients with COVID-19 who are currently in the hospital right now across

the country. So having that extra virus on top of our other seasonal viruses is certainly adding to the challenge. And it's, you know, making things very difficult. So if you're a caregiver or if you're yourself impacted by this illness, this is very difficult. If you're a clinician working in health care, this is a really difficult period right now. We had a couple of audience questions that were asking about the length of illnesses. So people saying they've been sick for 10 days, 15 days, even longer in some cases. So I guess I'm wondering, like, what have you heard from experts about this? Are illnesses lasting longer right now? Or do we have reduced immunity because we didn't really get sick during the pandemic? What would that come down to? I think there's probably a couple

of things at play. I'll mention the last part you said first. So there was this idea going around that has largely been debunked that, you know, because we weren't sick for so long, that we're kind of now more at risk from illness. When really what's happened is that, you know, people who didn't necessarily get impacted by illness for a couple of years, when we started mixing again and illnesses started going around, you just started getting sick again. When the dust settles, we'll be able to look back and say, this was actually a really bad year. We saw lots of people getting infected with lots of different things. It's hard to say right in the

middle of the storm exactly what's going on. You know, certainly anecdotally, a lot of people are getting sick. A lot of people are getting sick with numerous things. Whether or not people are getting sick for longer periods, I think is a bigger question. I think what experts would say to that in conversations that I have is that, you know, there's because there's so many viruses going around and a lot of people who are just at risk, maybe they haven't been vaccinated. Maybe they're just, you know, in close contact with people they haven't seen in some time. They're likely getting a couple of different things. Now, of course, with viruses like COVID, we know that that can lead in some people to longer lasting symptoms, to people feeling unwell for weeks on end.

I think it's fair to say that people are going to be experiencing more illness in the coming weeks before things start to settle down. So let's turn to the flu now, Carly, because as you mentioned a bit earlier, BC has announced that three children now under the age of 10 have died after getting the flu. Are we seeing data about flu numbers in kids across the country? We actually don't know what's going on with flu deaths in children across the country. And this is highly unusual because every year the Public Health Agency of Canada collects this data from a sentinel surveillance group. So essentially there's been a network set up that's been in operation for the past couple of decades that surveys hospitals, pediatric facilities and gathers information about children that are in the hospital as a result of the flu,

children that are in the ICU, children that have died, what's their age group and where are they located. And this information gets published published weekly as part of the Public Health Agency of Canada's Flu Watch program. This is the first year in really decades that that data has not been made available during the respiratory virus season. So starting in October, that data was basically not available according to the Public Health Agency of Canada. So I was looking at these numbers wondering what was going on. We discovered after a lot of reporting on this that the Public Health Agency of Canada, the federal government, has decided to switch service providers on who is collecting that data. And that group, for whatever reason, that data has not been made available. So whether or not

that group was not quite ready to go when they were awarded their contract in November, or if that data is sort of just being kept from public view, clinicians are quite concerned across the country that we don't really know what's happening overall with flu deaths. And so when health officials in BC have been, you know, very forthcoming and saying, here's what we're seeing, people in other provinces have not. We have not heard from Alberta. Alberta was dealing with a major influx of flu in December. We have not heard from Alberta. Alberta was dealing with a major influx of flu in December. We have not heard about any child deaths there from officials. So this is a huge black hole that can really compromise the ability of clinicians and health policy experts from, you know, mounting a response in real time and also giving a warning signal to the rest of the country as to what might be coming their way. I mean, Carly, we know that hospitals bear the brunt of respiratory virus season.

This is something you mentioned as well already. And just on Thursday, the Canadian Medical Association put out a statement saying that hospitals are, quote, woefully under-resourced for the avalanche of patients with influenza, COVID-19 or RSV at this time of year, unquote. So I'm wondering, what kind of impact are all of these illnesses having on our public health care system? I mean, it's been a very challenging few years for health care in Canada, and the hospitals are struggling across the country. You add in a respiratory virus season, there's patients who are in hallways. There's again, we're in a situation where season there's patients who are in hallways there's again we're in a situation where you know elective procedures that is non-urgent sort of life or death procedures are being cancelled or postponed children are waiting unacceptable amounts of time it's it's a difficult very very difficult period right now in health care it's difficult to be a patient it's

difficult to be a care provider the situation has not gotten any better. If any, it's staying the same or it's getting worse. There needs to be a fundamental change, according to people who work in the system, if we are to have a functioning health care system in the long term. Yeah, a few weeks ago, even Quebec's health minister actually told people not to come to the emergency rooms. I mean, because they couldn't handle it. That sounds pretty serious. Yeah, it is. I mean, it is very serious.

And I think that that's exactly the wrong kind of message to be conveying to people as well. I mean, people who are going to the emergency room are doing so because they feel they're in an urgent health care situation. That's also the last place that anyone really wants to be. You know, no one is choosing to go to the emergency room for fun. And so I think that when we're hearing those kinds of messages from people in positions of power, it suggests that there's maybe a fundamental lack of understanding as to what's going on on the ground and what needs to be done to help alleviate the crisis. And certainly, you know, we've had a major health agreement with federal government and provinces and territories this year. But still, you know, the change that we need to see happen has not yet happened. And as a

result, our hospitals are now again in gridlock and at a standstill because of respiratory illnesses. We'll be back in a minute. Let's turn to COVID specifically now. I was looking at some headlines about a new dominant variant in Canada, JN1. And I'm curious, how much are we paying attention to the new variants these days? Like, is this still important for us to know? You know, it is important. And it's funny because I was thinking back to, you know, two years ago when Omicron first came on the scene and how that really, I mean, it shut down schools and people were alarmed. It felt like, you know, we were back

to, you know, the starting point again. Whereas this JN1, which is a sub-variant of Omicron, is kind of similar in a sense in that it is infecting a lot of people. It is quickly, within a matter of weeks, become the dominant COVID variant spreading in Canada. But we don't pay the same attention. You know, these sub variants remain vitally important. And there's researchers and clinicians who are studying them all the time. And it's vital that they do so because we need to continue to understand where is this virus heading? How is it changing? It's going to continue to mutate. So is it mutating away from more severe forms into milder forms? You know, there's people who are monitoring these variants. And so far, there's nothing that to suggest that we're, you know, in a much different, more severe place with JN1. It just continues to be something that

we need to respond to and probably should be taking more protective actions against in just in terms of, you know, getting vaccinated and staying home and sick. Yeah. And when it comes to COVID, I know a lot of us are still using those rapid tests, right, to tell if we have it or not. How accurate are the tests in detecting these new strains? Yes, that has been a really hotly debated question. So I think there's a number of clinicians and experts who feel, you know, they've seen and a lot of us anecdotally have seen that the test effectiveness seems to have gone down. Experts say they're likely not as sensitive anymore, because the variants that were that are in circulation are looking a lot different than the variants that the tests were

designed to sort of look for. At the same time, there was a recent report out from Global News suggesting that the company producing the tests actually edited some of the results to make the tests look more sensitive than they were. But, you know, if you have those respiratory virus symptoms and you think you have COVID and you test negative, you know, test again. And then if those symptoms persist, I mean, just act as though you do have COVID or another, you know, contagious virus. I mean, you don't want to be heading out to a large family gathering if you have the flu or COVID. So, you know, take those, you know, just those, you know, common sense actions to try and reduce the spread.

What about what about vaccines? Like how well are the COVID vaccines matched to the variants that are actually in circulation now? Yeah, this is a really great question because we've seen a lot of anti-vaccine rhetoric that has, I think, undermined public confidence in the vaccines, when in fact, you know, the vaccines that are currently available are actually a pretty good match for the sub-variant that is in circulation. So very briefly, there was a new vaccine that was just approved a few months ago by Health Canada that was designed to protect against an XBB.1.5, like these names are terrible, but a sub-variant that was in circulation in early 2023. Vaccines made, it was put out, and of course there's a new sub-variant on the scene. Let's talk JN1 for instance. All of these variants I'm speaking about are sub-variants of Omicron.

They're close enough relatives that you're going to get good enough protection. So it may not be 100%. You may still even get some symptoms if you're infected with COVID, but you're going to get good enough protection. So it may not be 100%. You may still even get some symptoms if you're infected with COVID, but you're not going to get severely ill. There's less chance of spreading it. There's less chance of severe outcomes, which is better, especially for those individuals who are at heightened risk of severe outcomes. We did have an audience comment about vaccination, this person saying that they haven't been vaccinated this fall and don't get the flu shot because it's not particularly effective. How common are sentiments like that, Carly? Are people still getting vaccinated? Yeah, those sentiments are all too common and they're reflected in the vaccination numbers, which are, you know, really abysmal. dismal so the most current data from the federal government suggests that only around 15 percent

of the population has received a booster this fall one of the xbb shots that was approved this fall so essentially the vast majority of the population has you know little protection against the covid sub variants that are in circulation so when you hear a lot of people saying they're infected with covid that's likely one of the reasons why there There's a very contagious subvariant out there and almost no one has been vaccinated against it. Public confidence in booster shots started to decline. And I think part of that is, you know, vaccine fatigue and, you know, COVID fatigue. I think part of it is also maybe lack of access. There's not as many sort of, you know, mass vaccination clinics that are just at the ready pop-up clinics here and there. And I think part of it is also that lack of confidence. So there's so much information out there now on questioning

the vaccine. You've seen, you know, legitimate health authorities in places like the United States actually saying it doesn't work. These vaccines do work. And I think there's a there's a challenge here that we need to answer with lack of confidence. What about the flu shot, Carly? How effective is the flu shot? And is this something that people are getting? The flu shot has been available, you know, every year. And every year, the numbers are pretty low. We don't quite have numbers for across the country yet. But if you look at a place like Alberta, that does give out a lot of data, you know, the numbers there are quite low. I think overall, like less than one in four people have been

vaccinated. And if you look at it's the older age groups that have the highest vaccination rate. So people 60 plus have high vaccination rates. People in the younger age categories, even at risk children, the numbers of people that have been vaccinated are very low, even in the single digits. So and I think that those are likely trends that we'll see reflected elsewhere when we look back at this flu season. The idea that this that the flu shot isn't a great match. I mean, some years it's not as good a match. This year is actually a really good match. So the dominant strain of the flu going around is H1N1.

And the one of the strains that the flu shot protects against is H1N1. So if you're going to get vaccinated for the flu, this is a great year to do so because we know that there's a really good match there. So just lastly, Carly, I mean, given all of the stuff that we've talked about here, where do you think we'll be by the end of this respiratory virus season in Canada? You know, I think that the health care system will persevere as it has been forced to do. I think that at the expense of a lot of health care workers who are experiencing, you know, exhaustion, burnout, mental fatigue, you know, it's, you know, really runs the gamut. I think that we will get into the springtime, this will fade into the back of our minds until the next crisis hits. Unless we heed the calls and the expert advice from people

working within the system to really fundamentally rethink how primary care is delivered and how people are getting care in the community, I think we're going to continue to see these issues. I will say there's parts of the country, you know, BC has changed the funding model for physicians, Alberta is promising a lot of change, but it's hard to see how we really get to a better place. You know, we'll probably be having the same conversation a year from now is kind of what I fear unless we start to do things differently. Well, Carly, thank you so much for taking the time to be here today. Of course. Always happy to be here. That's it for today. I'm Maina Karaman-Wilms. Our producers are Madeline White, Cheryl Sutherland,

and Rachel Levy-McLaughlin. David Crosby edits the show. Adrienne Chung is our senior producer, and Angela Pachenza is our executive editor. Thanks so much for listening, and I'll talk to you next week.