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one vaccine dose not enough for return to normal, experts warn

quebec health authorities say loosening of restrictions cannot be based on vaccination rates alone.

by: rené bruemmer

as the pace of vaccinations mounts, so too does the yearning of socially deprived montrealers for a return to normalcy. mayor valérie plante is talking about reopening restaurant terrasses on june 1. quebec’s sleepaway camps have just gotten the green light to pitch tents for the summer. visions of attending open-air concerts are dancing in the heads of many.

but the question of how safe it is to launch back into group activities with only a portion of the population inoculated with just one dose hangs heavily in the air.

premier françois legault said last week he liked the saskatchewan model of linking the reopening of activities to the percentage of the population that has received one vaccine dose.

“i would like to be able to tell quebecers what is coming in june, july and august; when we will be able to return to a normal life,” legault said thursday.
in step 1 of their three-step plan, saskatchewan is proposing to reopen bars and restaurants (maximum six to a table), allow 150 people into places of worship and physically distanced fitness classes to resume, and permit groups of 10 people or fewer at private indoor or outdoor gatherings, three weeks after 70 per cent of those 40 and older are vaccinated.

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step 3, which would see the removal of most restrictions, would start three weeks after 70 per cent of the 18-and-over population has received a first dose. the government predicts step 1 would start the last week in may, and step 3 the second week in july, vaccination deliveries permitting.
“i think the saskatchewan strategy is interesting, because it will encourage people to go get their first dose,” said roxane borgès da silva, a professor at the université de montréal’s school of public health. the public health agency of canada has recommended restrictions can be loosened without impacting the health system once 70 per cent of canadians have received a first dose and 20 per cent a second.
matthew oughton, an infectious diseases specialist with the jewish general hospital, also applauded the saskatchewan model on twitter but said it needs to be combined with an up-to-date release of data to further motivate the population.
“take saskatchewan’s ‘road map’ and add in a new brunswick-style covid-19 dashboard that displays real-time progress towards roadmap goals … ideal combo of transparency, public health (science communications) and semiotics,” oughton wrote.
quebec’s health minister christian dubé and public health director horacio arruda, however, were lukewarm to saskatchewan’s model, saying it was overly simplistic to base the loosening of restrictions on vaccination rates alone.

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“we look at vaccine coverage, but we must also look at what’s happening in terms of the pandemic, where are the outbreaks, where are the hardest-hit regions, how many people are in hospital, in intensive care,” arruda said thursday. “because there, we will have younger people, who often have to stay longer in the icu.”

plante’s call for terrasses to be reopened by june 1 was brusquely shut down by dubé , who said quebec needs to be careful about raising false hopes before public health authorities have determined if it’s safe or not.

quebec’s health departments are studying best practices to decide how to proceed with reopening. in the united kingdom, where slightly more than 66 per cent of the population has received one shot, terrasses have reopened and restaurants and bars are set to open for indoor seating on may 17. in israel, where more than half the population is fully vaccinated, a “green pass” allows the inoculated access to gyms, hotels, restaurants, public swimming pools, live concerts and movie theatres. masks are still mandatory in indoor public spaces, but an outdoor mask mandate has been lifted.

in the united states, the centers for disease control and prevention published an optimistic forecast wednesday suggesting the pandemic could be largely curtailed by july, at least temporarily, if the country meets president joe biden’s goal of inoculating 70 per cent of americans by july 4.

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according to documents from public health ontario, while a first dose will lead to a reduction in case rates that can lower some restrictions, the effects of a first dose take weeks to develop, and it does not offer the same protection as being fully vaccinated. easing public health measures for those with only one dose is not advisable, the authors wrote. canadian health officials have stressed that while the country is in the midst of a third wave, citizens must maintain public health measures like masking and physical distancing even if they’ve had one or two doses.

borgès da silva said it is likely outdoor restrictions will be eased as vaccination rates increase, but simpler things, like mandating the wearing of masks in grocery and retail stores, should be maintained because the protective benefits outweigh the minor inconveniences.
there is also the concern that many will forgo their second dose, in a misplaced fear of unpleasant side-effects or the belief that a first dose is sufficient.
second doses are crucial, she said, because they increase immunity, whereas the protective effects of a first dose wane significantly with time.
with files from the national post.

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