No longer an official emergency in B.C., COVID-19 remains a crisis

One in 52 British Columbians currently has COVID-19, says infectious disease expert Tara Moriarty. (Michelle Gamange, Local Journalism Initiative)

British Columbia’s top doctor has ended the COVID-19 public health emergency, which began nearly 1,600 days ago on March 17, 2020.

Declaring COVID-19 a public health emergency gave provincial health officer Dr. Bonnie Henry the ability to issue mask mandates, travel and gathering restrictions and vaccination requirements for health-care workers to curb the spread of the virus.

While experts The Tyee spoke with agree the public health emergency may no longer be needed, they stressed that COVID-19 still poses a serious and potentially deadly threat to the general public.

“COVID is still a major, ongoing health issue and crisis,” said Tara Moriarty, an associate professor at the University of Toronto, an infectious disease expert and co-founder of the COVID-19 Resources Canada database.

By Moriarty’s calculations, one in 52 British Columbians currently has COVID. According to recent federal wastewater testing from mid-July, Canada and B.C. have “high” COVID-19 activity levels.

This can have major implications for public health because hospitals don’t have mandatory masking requirements.

Think of a hospital waiting room where at least one person is likely to be infected, or how many patients or staff might be infected in a major Canadian hospital that has 500 beds and thousands of staff, Moriarty said.

She estimates that around 40,000 Canadians died in 2022 due to COVID and that 2023 had a similar number of deaths.

These deaths are reported as “excess mortalities” through Statistics Canada.

“Excess mortalities” are adjusted for things like population growth, toxic drug deaths and cancer rates, which means the unexpected deaths that remain are likely due to COVID-19, Moriarty said.

Last week Henry said the general public has a “high protection rate” against COVID-19 thanks to “hybrid immunity,” vaccinations, the widespread normalization of staying home when sick, wearing masks and covering your cough.

Hybrid immunity comes from a combination of vaccines and past COVID infections and, according to Health Canada, offers higher protection than immunity from infection or vaccination alone.

Relying on immunity instead of mitigation measures is “problematic” because hybrid immunity only ever offers temporary protection and Canadians aren’t keeping up to date with their vaccinations, said T. Ryan Gregory, an evolutionary biologist and professor in the department of integrative biology at the University of Guelph.

Moriarty also warned against relying on hybrid immunity, pointing to a 2023 study that found hybrid immunity wanes over time and can’t protect against new immune-evasive variants.

Vaccines help prevent serious acute illness and chances of developing long COVID, but they don’t prevent transmission. According to the federal government, 23 per cent of British Columbians have been vaccinated with the XBB.1.5 vaccine (first distributed in the fall of 2023 and offered again through the spring 2024 campaign).

This represents one of the highest vaccination rates in the country, where the national average is 18 per cent vaccinated — but it’s still less than one-third of B.C.’s population, and that COVID strain is no longer dominant, Gregory said.

The BC Centre for Disease Control’s website reports that nearly 100 per cent of COVID cases in B.C. in June were from the JN.1 variant.

Low vaccination rates and no other mitigation measures mean that this highly infectious disease will keep spreading.

“The more cases you have, the more you’re going to end up with new variants evolving,” Gregory said. This increases the chances that a variant will evolve to get around existing immunity, he said, adding that “there is no automatic tendency for viruses to become milder or seasonal.”

Wastewater testing

Devon Greyson, an assistant professor in the school of population and public health at the University of British Columbia, said ending the public health emergency is a procedural, bureaucratic move that signals B.C. is ready to start looking at long-term policies rather than emergency temporary ones.

The Public Health Act has emergency measures that give a public health officer temporary powers in a crisis to do things more quickly with less deliberation, they said, adding that this is not something you want on an ongoing basis in a democratic society.

Public health experts will be reviewing policies brought in under emergency orders and seeing what should be scrapped — closing bars and restaurants, for example — and what should be extended, they said.

Greyson said one policy they hope sticks around is wastewater testing, which is one of the “best ways” to keep tabs on the prevalence of infectious diseases like COVID-19, respiratory syncytial virus or RSV, influenza and polio, and even sexually transmitted infections.

Not everyone agrees the program is worth it; Ontario ended its wastewater testing program on July 31.

Health-care workers no longer need to be vaccinated for COVID-19

Ending the public health emergency also means that as of July 26, health-care workers in B.C. are no longer required to be vaccinated for COVID-19, and any worker laid off during the pandemic because of their vaccination status can return to work.

Instead of a ban, B.C. will have a provincial database that tracks the vaccination status of public health-care workers for major diseases like COVID-19, the flu, measles, mumps, rubella, hepatitis B, whooping cough and chicken pox.

This will allow public health to know who needs to mask up, have modified duties or be excluded from work in the event of an exposure or outbreak, Henry said.

Gregory said the database is a good idea for some diseases, in particular for some vaccines that do protect people from infection. But when it comes to COVID-19, he said, the vaccine doesn’t prevent transmission.

“Relying on vaccinations as the measure of whether people are likely or not to transmit [COVID] to vulnerable patients is a very dangerous strategy,” Gregory said.

Instead, he added, it would be best if everyone wore masks in public health settings whenever possible.

Mitigation measures such as properly worn N95s, HEPA air filtration, ventilation and avoiding high-risk areas like indoor crowded spaces are “all variant proof,” Gregory said. “No variant has evolved to circumvent an N95.”

The Tyee asked the Health Ministry how many public health workers might be able to return to work now that the ban is lifted but did not hear back by press time.