Volume 9 • 2022 • Issue 1

I hope that this recent spike helps us appreciate the protection that vaccination gives us and that more people will get vaccinated. The views expressed are those of the author and do not necessarily reflect the opinions or official policies of the Canadian Dental Association. Q What does this latest wave mean for dentistry in Canada? AB: For many dentists, our vigilance and caution in our lives outside of our practices worked well to prevent us getting COVID. Now, we have to reconsider everything that we do outside the operatory because of increased risk. Personally, I’ve had to cancel travel plans and re‑consider all the strategies that I had in place to protect myself and my other half because we both have jobs where we work with high-risk populations. The Royal College of Dental Surgeons of Ontario made some changes to protocols for dentists before Christmas, which include always wearing an N95 respirator when a staff member is in potential contact with patients (p. 19) . We’re in a difficult time; many dental offices take time to regroup between Christmas and New Years and now we’re coming back to a complicated situation that we’re all trying to figure out. We’re reading the news and listening to public health messages and there is a lot of variation in this messaging, which makes a complex situation feel even more chaotic. It’s reasonable to feel confused. Q It seems that in South Africa, Omicron both peaked and declined fairly quickly. Would you expect a similar pattern of infection in Canada? AB: In mid-December, South Africa was averaging about 20,000 new COVID cases a day. Now, a month later, they are down to about 6,000/day. The theory is that in a spike like this—and I deliberately say spike because the shape isn’t a curve like other waves—an extremely infectious virus quickly infects almost everyone and then declines because it has run out of people to infect. The South African numbers, and more recent indications that case numbers might be flattening in places like New York, do make me hopeful. But I’m also waiting to see what happens in Europe, where Omicron only emerged at the end of November. Q We’ve seen some media reports use the word “mild” to describe Omicron. Do you feel that term is appropriate? AB: Less severe is more accurate than mild. Fewer people need to be hospitalized. Fewer people need to be treated in intensive care or put on ventilators than those infected with an earlier variant. But the sheer number of infections means that a number of people are still getting very sick. People who might have an underlying health condition, or for some genetic reason we don’t yet understand, may need medical intervention because of an Omicron infection. This wave of infection is different: too many people need care during a time where hospitals are battling staff shortages because there are now greater levels of infection among staff. Our health care system is currently under a lot of strain. Indeed, something I’m very concerned about is people who can’t get necessary surgeries because hospitals are caring for COVID patients. So you don’t want to use the term mild as this suggests there is no risk. There is a risk, but it is less severe for more people, particularly those who are fully vaccinated. Q What’s the best-case scenario going forward during the “viral blizzard” of Omicron that we are experiencing? And what’s the worst? AB: It feels like we’re walking through a viral blizzard to me. It’s just everywhere. Any maybe it will pass quickly, like a blizzard, and we’ll move closer to living with COVID as an endemic illness. There may be shots for it every winter, like we have for the flu, and hopefully there won’t be such intense disruption to our lives. I’m crossing my fingers that this will be the case. One of the questions I have is what would it look like if an endemic version of COVID like Omicron comes along and removes 20 to 40% of people out of the workforce during the same few weeks? This is what we are seeing now and it’s causing incredible disruption to the economy. But as long as it doesn’t cause severe illness, the health care system should be able to handle it. The worst-case scenario? I truly hope that we don’t end up with a variant that has the infectiousness of Omicron that also causes more severe illness. We’d run out of health care capacity in a heartbeat. I hope that this recent spike helps us appreciate the protection that vaccination gives us and that more people will get vaccinated. There are significant differences in the death rate in places with high vaccination rates versus those with low vaccination. 10 | 2022 | Issue 1 CDA atWork