By Morgane Oger

British Columbian families and households have watched waves of the coronavirus COVID-19 SARS-2 pandemic knocking us all down for two years, and we know there are more on the way.

We have all been worrying as we scramble to keep our family members safe—even if they can't be vaccinated. Moms and others caring for children under five tell us that the Omicron virus scares them. They tell us that they feel that measures being taken leave their family vulnerable. They say they want to see more done.

The educators who spend the day with our children agree, and I do too. I agree it’s time to take additional measures to protect everyone who cannot be vaccinated to help flatten the curve. However, we must also accommodate people with disabilities and leave no one behind.

In considering the test for establishing a “physical disability” as a personal characteristic protected from discrimination, the concept of disability has generally been held by the courts to involve a physiological state that is involuntary and has a degree of severity, of permanence, and/or persistence.

B.C. legal decisions have upheld that "disability impairs a person’s ability to carry out the normal functions of life to some degree and poses an impediment to a person’s participation in the economic or other areas of life which the Code seeks to protect against”.

British Columbians who cannot be vaccinated for COVID due to medical reasons are therefore covered by the B.C. Human Rights Code under the personal characteristic of disability. They must be reasonably accommodated up to the point of undue hardship wherever the B.C. Human Rights Code applies—in services, in employment, and in housing.

In an October 2021 B.C. Human Rights Commission policy guide, the Commissioner wrote that the proof-of-vaccination requirement is justified from a human rights perspective and will result in increased protection for those among us who are most vulnerable to the virus. Asking for this proof is needed as long as the threat from COVID remains high.

There are three measures experts and advocates tell us would help accommodate people most at risk of Omicron’s complications. These should be implemented. We need to act as quickly and gently as possible.

1. Require proof of immunization in indoor public spaces and at the workplace

I would like to see the B.C. government require proof of immunization in all indoor public spaces and workplaces. This preventive measure needs to apply to anyone who is not medically prevented from being immunized. It should remain in place for the duration of this health emergency. The Canadian health minister has said he feels that it's needed and feasible for the provinces to apply this constraint.

Vaccination is the only means available today to actually protect every person who can be immunized. Making vaccination a requirement will help reduce the already severe strain on our health-care system and hospitals. It will help flattening the curve. Requiring up-to-date immunization will also help reduce the impact of future COVID waves. We need to have vigorous conversation about what this will do for us and what it will cost us as a society.

2. Adequately accommodate households impacted by COVID-19

In a July 2021 opinion piece in Scientific American, Dr. Claire Pomeroy warned that health insurers and providers need to plan for what she called “a tsunami of disability as a result of long COVID”. We have to go further than this. We must also support households with a member who cannot be exposed to COVID by family members who carry it into the home from outside.

A September 2021 study by Oxford University and the U.K. National Institute for Health Research reported one in three patients who contracted COVID was experiencing at least one "Long COVID" symptoms three to six months after the event. The most common symptoms were breathing problems, abdominal symptoms, fatigue, pain, and anxiety/depression. These persons must not be left behind.

I would like to see the provinces work with the Canadian government to establish a program to provide new funding to support household with a family member who cannot be immunized. Such a program is needed as long as provincial health guidelines allow COVID to be present in indoor public spaces in concentrations likely to result in infection. Because of the lack of prevention in the public space, families have no choice but to avoid all indoor public spaces when one of their family members cannot be vaccinated for medical reasons.

In British Columbia, funding could be made available through an existing provincial assistance program under the Ministry of Social Services and Poverty Reduction.

3. Set and enforce ventilation and filtering requirements that address aerosols in public spaces 

To reduce the risk of anyone bringing COVID home when vaccinated, I would ask municipalities to work immediately with their provincial government to adopt building standards and operation guidelines that require effective filtration and decontamination solutions in all heating, ventilation, and air conditioning systems for any indoor public spaces, any indoor worksites, and any rental housing.

If possible, I would like to see these tied to the annual licensing of businesses for enforcement purposes. Keeping licensees accountable for these hygiene measures will help slow down the long-overdue airborne transmission of airborne viruses. To help manage the financial burden of updates, I would like the federal or provincial governments to support owners of commercial buildings by implementing a program to fund and amortize the cost of such improvements over a number of years.

The three initiatives above are under the purview of elected officials. Making them happen is likely to take too long to be useful for the Omicron strain but we know it is inevitable more strains are coming. Elected officials are too easily tempted to delay implementing solutions they know are needed. If these measures were already in place, the curve would have been significantly flattened with Omicron.

What the data is telling us is coming

Because I have a background in engineering and sciences, I am fond of evidence-based policy. The best policies are driven by data from objective studies showing they are needed to achieve the desired outcomes. So let’s look at the data and projections.

Provincial and federal Centres for Disease Control have been working diligently with B.C.’s health authorities to keep us all safe by implementing health orders that mitigate the fast-moving situation. The positive results of their hard work are clearly visible in hospitalization and fatality statistics when compared to those of similar regions.

The projections in the January 6 report of the independent and highly regarded B.C. COVID Modelling Group tell us that Omicron is established and spreading in B.C., and that infection rates are growing at 25 percent per day, doubling every 3-3.6 days. They tell us that demand on hospitals will be severe in the upcoming weeks at 4 to 10 times what B.C. saw in previous waves.

The report expresses the Government of Canada's concern that COVID may be spread as aerosol droplets so COVID virus particles linger in a space for a considerable amount of time and do not fall to the ground as quickly as larger droplets. They need to be moved away by air flow through filtration. The report also tells us an unvaccinated person has the same risk of catching this strain of COVID-19 as a vaccinated person does but faces 20 times the risk of hospitalization and an average hospital stay.

Currently, half of hospitalizations due to COVID are for unimmunized persons. Reducing the number of unvaccinated persons will significantly increase hospital bed availability.

The report projects the peak for the Omicron wave may happen as early as late January. The report also tells us what we have already been told by the BCCDC: that without an additional booster, previous immunization is 100 percent ineffective at preventing infection within 20 weeks of the last jab. Projections based on models are susceptible to uncertainty, but they give an indication of an evidence-based estimate of future outcomes based on past results.

The report warns that there is a 50 percent chance of someone being infected with COVID when ten persons are gathered and that the likelihood jumps to 92 percent when 50 persons are together. It projects that most British Columbians will have come into contact with Omicron by the time the wave has passed.

The report recommends that everyone able to get immunized do so as soon as possible.

Statistics Canada reports over 1.6 million families with at least one child 5 or under in Canada. In BC, there are over 200,000 children under 5, none of which can be vaccinated as of January 2022. If a person’s participation in society is impacted by COVID due to a disability, Canada must not leave them to fend on their own without a safety net.

The report recommends that measures be taken to effectively filter out COVID. It tells us that we need to do better at isolating unvaccinated persons from risk of infection because the complications that unvaccinated persons experience from COVID-19 are projected to overwhelm our hospitals.

Effective face coverings such as N95 masks do help keep us safe from inhaling COVID when we wear them, but they only work when actually worn and nobody wears a mask 24 hours a day. The spaces in which we spend time need to be upgraded to remove the virus and upgrading ventilation will do this effectively.

People in households with an unvaccinated person face a serious problem: the more widespread COVID is, the higher the probability that an vaccinated family member will catch COVID in a public space and bring it into the home. As long as not all members of a household are vaccinated, everyone in that home needs to keep everyone safe from COVID and needs to avoid all indoor public spaces. They need to be accommodated at work and in services—including provincial harm-reduction programs.

Support those who need it

As a whole, we have a collective interest as Canadians to keep our society going and to keep British Columbians working while keeping us all safe and there will always be some of us who can not be immunized against COVID who we cannot leave behind. I have two teenage children in school. Like many separated parents experienced, I view my children’s safety concerns as non-negotiable. I am also mindful that like so many Canadians, both me and my partner experience underlying risks, like my parents also do.

Like  many other Canadians, keeping everyone in our family safe is why we abstained from many holiday rituals in recent weeks that we would have loved to enjoy. I strongly believe we must leave no one behind and many households have a member who cannot be vaccinated.

This is why I expect our health authorities to ensure that in any indoor spaces, everyone is up to date on their COVID vaccinations like they are, or has a medical exemption.

It is why I would like to see bylaws and construction standards to ensure all indoor spaces are effectively ventilated or filtered to protect against airborne viruses such as the coronavirus.

And it is why I want to see that we support everyone impacted by an inability to access immunization and needs to be kept safe from it. These people should be accommodated as long as their vulnerability to COVID persists.

We are all concerned about the future. We are all tired, and this is a time when it is inappropriate to engage in divisive politics by spreading disinformation to cause fear and anxiety. We're always better off working together than sniping at strangers. I pledge that whatever comes, I will listen to my own advice and will do my part in making things better. I hope you and our neighbours will join me.

Sources

Government of Canada: COVID-19: Main modes of transmission

B.C. Human Rights Commission Policy Guide: COVID-19 Vaccine Card Guidance

Oxford University: Over a third of COVID-19 patients diagnosed with at least one long-COVID symptom

B.C. COVID Modelling Group January 6 video link

Sunrise Poultry Processors Ltd. v United Food and Commercial Workers International Union, Local 1518, 2017 CanLII 26448 (BC LRB)