COVID-19 in Canada: The catch-22 of lockdowns

New research suggests shorter, more frequent lockdowns are better for public health and the economy

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      The bad news is that this may not be the last winter that we’ll have to endure another cycle of on-again, off-again hibernation because of COVID-19.

      Some modelling is already predicting the third wave in mid-April. Even with a vaccine, some 80 percent of the population will have to be vaccinated to provide a bulwark against the disease. There continue to be a lot of moving parts when it comes to managing the coronavirus. And if we’re being honest, we likely won’t be out of the woods until 2022. The good news is we’re more than half way there. It’s been a blur.

      Of course, this could have been avoided, most epidemiologists agree, if Canada had followed the example of Australia and New Zealand, and put the hammer down earlier with longer lockdowns during the first wave of the virus and at the beginning of the second wave.

      The U.K., for example, has decided to lock down until the first day of summer (June 21) under its recently announced “roadmap” out of COVID-19. The plan is to lift the current lockdown in four stages, each lasting five weeks. The first order of business under the U.K.’s plan is the reopening of schools on March 8.

      But even the June 21 target may be too ambitious, experts say, given the new variants of the virus floating in the breeze. Despite the successful rollout of the vaccine, the U.K. is still registering some 10,000 new COVID cases daily.

      David Nabarro, the World Health Organization’s special envoy on COVID-19, raised eyebrows at the beginning of the second global wave last fall when he said that the WHO “do not advocate lockdowns as the primary measure for the control of the virus”. In other words, lockdowns shouldn’t be the primary strategy to fight the virus. As we’ve seen in other countries with robust testing and contact tracing in place, lockdowns have been the exception, not the rule.

      “Lockdown’s really are a last resort,” Burlington-based family physician Jennifer Kwan says. “They’re a demonstration of failure.”

      And so here we are a year later.

      There’s a point of diminishing returns when it comes to getting people to adhere to public health restrictions. Some new modelling by researchers at York University suggests the longer lockdowns go, the more likely they are to induce COVID fatigue and cause people to start breaking the rules.

      “This is not some well you can keep going back to again and again,” says Iain Moyles, an associate professor of mathematics and statistics at York University’s Canadian Centre for Disease Modelling (CCDM), whose research was recently published in the journal Royal Society Open Science. “Every time you stay home you’re incurring a cost to yourself. That could be a literal economic cost or it could be a social cost like not seeing your friends or loved ones. And that’s the part that starts to wear.”

      Moyles says that “social fatigue”, can diminish the effectiveness of lockdowns and lead to worse health outcomes and increased costs. What is the exact breaking point is highly individual and depends on a host of factors.

      Fear, for example. During the first wave when we didn’t know as much as we know now about the behaviour of the coronavirus—in particular, the threat posed by aerosol transmission—most people who could were happy to hibernate.

      But even with the increased chances of transmission posed by new variants, Moyles says fear is only one variable for people when weighing the risks. How many people, for example, are still taking into account factors in their daily decisions like the fact that COVID-19 is an asymptomatic disease and can be spread by people not showing any outward signs?

      The availability of a vaccine will play a larger role in the decision-making process of assessing risk. Hopefully, it won’t be a case of offering people a false sense of security.

      “People who have been vaccinated can be safely seeing other people who also have been fully vaccinated, including the few weeks after your second dose,” Kwan says. “But there’s a lot of nuance to that, right? You can’t really tell who else is vaccinated if you go to a grocery store.”

      Which means physical distancing and masks for the foreseeable future. Of course, staying at home is still recommended.