Volume 8 • 2021 • Issue 5

Dr. Aaron Burry, leader of the CDA COVID-19 Response Team and CDA’s Deputy CEO—Professional Affairs, answered questions in September about dentistry in the context of the pandemic. Q What have we learned about our COVID response in the last few months? Dr. Aaron Burry (AB): In general, there have been three different approaches that governments have adopted to deal with COVID. China and New Zealand, for example, have a “zero case” strategy. This policy approach focuses on the total elimination of COVID in the whole population. Intense public health measures, such as complete lockdowns, intensive case tracking and testing of all residents in a community, are not uncommon. The goal is to stamp out the virus entirely right from the outset of the first detected case. At the other end of the spectrum, some governments have adopted a policy approach that would accept the notion that COVID-19 should be treated as an endemic illness, similar to seasonal flu. Early on, this approach was adopted by Sweden. More recently, we’ve seen it in the United Kingdom and in certain states in the US. There are vaccinations, but there is a general acceptance that the disease will be pervasive in the population. The assumption is that if the pandemic is allowed to run its course, people will eventually build herd immunity. As a result, there are fewer restrictions or public health measures imposed. In Canada, we’ve largely taken a hybrid approach, somewhere between these two extremes, in which vaccination and public health measures are used with the goal of managing the extent of an outbreak rather than trying to achieve zero cases. In some provinces and territories, we’ve been closer to the zero case strategy. In others, largely in Western Canada, we’ve been closer to the endemic approach. Within this middle ground, certain public health protocols have been relaxed in recent months. Gatherings are allowed and the use of masks has waned in some places. Over the summer, we’ve seen the results from all of these approaches, and the outcomes are worrying. Determining the optimal circumstances of when to transition to considering COVID endemic and relaxing public health measures remains unclear. With other diseases, high levels of vaccination proved very effective. But COVID is different. It evades our public health measures and finds unvaccinated people in the population at an alarming rate. The challenge is that these unvaccinated people often become seriously ill, which puts tremendous stress on our medical system. Rates of hospitalization have risen dramatically and reversed the gains from the late spring. Q What do the latest COVID numbers look like? AB: In mid-July, Canada had daily new cases of about 390. Now, in mid-September, we’re at more than 5,500. Some provinces are seeing worse case numbers than others. Nationally, hospitalization rates for COVID have nearly quadrupled since mid-July. On August 15, there were no COVID-related deaths reported in Canada. But since then, the daily average has crept up to about 25. When looking at international numbers, some countries have been struggling for months and are in a very difficult place with COVID right now. Iran saw 40 deaths per 100,000 people last week. The US is at 30 per 100,000 and France 10 per 100,000. In Canada, the number is 3 per 100,000. These are all countries in which vaccines are available and significant percentages of people are vaccinated; yet COVID continues to be associated with hospitalizations and deaths. The lesson from the last couple of months is that even if only 10% of a population is unvaccinated, the Delta variant can be extremely harmful. Compared to other countries, Canada’s numbers are low, but we are seeing week over week increases in infection, hospitalization and deaths. I’m very concerned about the Delta variant of COVID because it seems to infect so many individuals quickly and a high proportion of unvaccinated people are landing in ICUs. Once again, the numbers tell us that 90% of Dr. Aaron Burry Your COVID-19 Questions Answered 11 Issue 5 | 2021 | CDA atWork