Volume 9 • 2022 • Issue 1

Dr. Aaron Burry, leader of the CDA COVID-19 Response Team and CDA’s Deputy CEO, answered questions in mid-January about dentistry in the context of the pandemic. Q Things have changed since our last Q&A article. Where are we in the pandemic now? Dr. Aaron Burry (AB): Back in November, it felt like we were on a good path; in Canada, case numbers were low and vaccination levels were fairly high. We always knew there was a possibility that a new variant could change the trajectory of the pandemic. And now that has come to pass. The Omicron variant has moved like wildfire across the world. Omicron is so infectious that it has rewritten the rules practically overnight regarding what effectively reduces the risk of transmission. This week, there were 3 million new cases reported a day globally compared to 500,000/day in mid-November. In Canada, there were about 40,000 new cases reported a day compared to 2,500/day in mid-November. Dr. Michael Osterholm, an American epidemiologist, used an analogy to compare the Omicron variant to other COVID variants. It’s as if the first COVID-19 virus was a snowfall. The Delta variant was a major snowstorm and the Omicron variant is a full-on blizzard, a viral blizzard! With such rapid transmission, pretty much all of us know a friend, patient, colleague or family member who has contracted COVID. The silver lining is that despite very high levels of infection, hospitalization and deaths do not seem to occur as often during this wave. Two things seem to be at work here: vaccination prevents people from getting really sick and the Omicron variant causes less severe illness. Q Does the Omicron variant change how we should respond to the pandemic? AB: The things we were doing, as a society, to prevent transmission don’t seem to be working as well as they were. With the earlier COVID-19 virus, 2m of distance and masks was an effective protocol. It seems that with Omicron, the viral load is high enough that even short, casual contact in an indoor space can transmit the disease. For example, in the US airline industry in December, protocols that were used on airplanes were working well. But then suddenly with Omicron, a large proportion of flight crews, who, despite wearing surgical masks, were infected and thousands of flights had to be cancelled because there was simply no one to staff them who wasn’t sick. So, a protocol works until it doesn’t. Right now, I have a sense that we are “flying in the dark” because the case numbers are inaccurate. It’s very hard to measure how many people are infected with COVIDwhen asymptomatic infection is common. Even hospitalization numbers aren’t as useful as they once were. In earlier waves of the pandemic, it was pretty clear when people were severely ill from COVID and had to be hospitalized. Now, many people who are in hospital for other reasons are contracting COVID during their hospitalization. I just read that of the 3,630 COVID-related hospitalizations in Ontario reported today, 54% were admitted for COVID and 46% contracted COVID after admission for other health-related conditions. The infection control measures and physical separation that hospitals and long-term care facilities were using during the past year with success, no longer work with Omicron. I know that people are tired of hearing the word unprecedented, but the speed of transmission of an airborne respiratory illness like this is something that we haven’t seen before. The outbreaks are so expansive. But on the other hand, we are lucky that severe illness is less likely with the Omicron variant and it seems to be more of an upper respiratory illness that is less likely to affect the lungs. Dr. Aaron Burry Your COVID-19 Questions Answered 9 Issue 1 | 2022 | CDA atWork