The decision by provincial and territorial governments to limit the collection and reporting of COVID-19 data has left Canadians navigating what some experts call the most uncertain wave of the pandemic to date. Most jurisdictions have stopped trying extensively and now limit or consolidate data such as hospitality indicators. Many have also reduced the frequency of public reporting from daily to weekly. Governments that have done so – including BC, Alberta, Saskatchewan and Manitoba – attribute the shift to the fact that it is now more valuable to observe trends over time than to fluctuate daily. However, those who worked to prepare Canadians for what might follow say they are now blinded by the removal of the last remaining public health measures, and Omicron’s BA.2 variant fuels a resurgence of cases. “The absolute worst moment to change your data streams is the rise of a new variant, and here we are,” said Sally Otto, a professor at BC University and a member of the independent BC COVID-19 Modeling Group. . “I can not make model predictions about the number of hospitalizations coming, because I really do not know how many people became infected in the first [Omicron] wave, and when, and how high their immunity is. “I would argue that we really have no idea whether or not we will see the same treatments as our first wave or less. It could be so much more and we enter into it without knowing it. “ Dr. Otto said the reason it could be so much more is because the most vulnerable populations were protected by recent amplifiers during the first Omicron wave. Last winter, the highly contagious Omicron variant pushed COVID-19 cases to unprecedented peaks, pushing most provinces to limit the use of polymerase chain reaction (PCR) laboratory tests to those at higher risk. This had consequences that extended beyond monitoring the amount of COVID-19 in the community. The independent modeling team of which Dr. Otto released its 20th report on 6 April. He called the BA.2-guided wave the “most uncertain point ever in the pandemic for modeling” because of poor data on the total number of recent infections and the extent of immunity leading to this latest wave. Without adequate testing, the team of experts in epidemiology, mathematics and data analysis says it cannot study the vaccine and enhance its efficacy against infection or hospitalization, by age. They also do not have a good sense of susceptibility to re-infection, which is based on knowledge of previous infection. Also, BC hospital admission data is irregularly updated with health authorities, leading to large fluctuations in daily admission estimates. “We can not handle and mitigate risks that we do not know are coming,” said Dr. Otto. Her team would like to see a random sampling of the population tested for COVID-19, either as part of a workforce (such as healthcare workers), through a random census (such as sending test packages by mail) or by tests of those admitted to hospital for non-COVID reasons. Peter Juni, the outgoing scientific director of Ontario’s independent scientific advisory panel COVID-19, also said there must be a realistic approach to continuing disease surveillance trials. “We need to replace extensive clinical trials with something that is affordable and gives us the information we need, and that is a random human sample,” he said. Dr Juni said wastewater monitoring was an important tool to help Ontario navigate the Omicron waves. An analysis of sewage signals from treatment plants showed that the province probably had between 110,000 and 140,000 infections a day during the first Omicron wave during the winter, he said. The current BA.2 wave has reached between 100,000 and 120,000 infections per day, and provisional estimates released this week indicate that infections may have peaked. However, Dr. Johnny noted that there is still considerable uncertainty, attributed to factors such as the decline in vaccine immunity, changing weather and the way people have chosen to behave in terms of lifting public health restrictions. He added that there is also a growing amount of immunity gained from infection, but it is impossible to determine how much. “To give you an estimate, Ontario, with 14.7 million people, we could be anywhere between the estimated 4.5 million and six million infections that have occurred since December 1,” he said. June. “That’s a big difference.” The Center for Health Informatics at the University of Calgary maintains a wastewater control panel for Alberta, while BC wastewater monitoring is limited to five treatment plants in Vancouver Metro. The University of Saskatchewan monitors wastewater treatment plants in Saskatoon, Prince Albert and North Battleford. Canada’s Director of Public Health has acknowledged the impact of reduced PCR testing. “PCR continues to be important,” Theresa Tam told a federal news release Tuesday. “Even with a drop in trials, and because they are more targeted at the higher risk population, we need to have more representative trials where possible. So I think this should continue to be encouraged. “ Michael Wolfson, a former assistant chief statistician at the Statistics Office of Canada and now a member of the University of Ottawa Center for Health Law, Policy and Ethics, said Canada’s data collection infrastructure was inadequate and raised questions. give or take”. He noted that while provinces and counties manage and provide health care in Canada, providing statistics is a federal responsibility. He said Canada would have benefited from a national, integrated COVID-19 monitoring system with standardized data, and blamed “provincial obsession” and constitutional conflict of jurisdiction as obstacles. “Health data is not healthcare,” said Dr. Wolfson. “It’s closely linked and closely linked to healthcare, but as far as statistics are concerned, it’s federal jurisdiction. So the federal government, in my view, should be willing to say to the provinces: ‘Sorry guys, do you want another $ 20 billion a year to increase your federal contribution? “If you do not catch up, you know, work together and work together to get decent data, we are not going to give you all that money.” Kerry Bowman, a professor of bioethics and global health at the University of Toronto, said there were “definitely” concerns about reducing the COVID-19 data available. “Good ethics is based on good science, and good science is based on good data, and we have none of that,” said Dr. Bowman. “When you turn to people and say, ‘Now you have to take individual responsibility, not just for yourself, but for the vulnerable people in your life,’ you can not expect people to make good decisions without facts.” Sign up for Coronavirus newsletter to read the basics of the day about coronavirus, features and explanations written by Globe reporters and editors.
