Alberta's COVID-19 public health measures are gone. What's next?

Doctors and scientists are cautioning Alberta will likely have to reinstate some public health measures, the last of which were lifted this week, in the face of future COVID-19 waves.

As of midnight Tuesday, the province's mask mandate for public transit was eliminated along with the legal isolation requirement for people who test positive for COVID or have symptoms.

Isolation is now a recommendation only.

"To drop something as simple and as vital as isolating if you have an illness just seems very premature," said Dr. Shazma Mithani, an Edmonton ER physician who is surprised by the move.

"My concern is that as these isolation measures and protections are dropped, the cases will start to rise again [and] we'll start to see an effect on our hospitals that are already very, very stressed."

Past the peak

COVID-19 transmission is on the downturn and it looks like Alberta is past the peak of its BA.2 wave, according to Sarah Otto, a University of British Columbia zoology professor and member of an independent COVID-19 modelling group.

"Now we're seeing the numbers come down," said Otto, who tracks COVID-19 trends in Canada. 

She warns, though, new subvariants, including BA.4 and BA.5, which are already circulating in Alberta, could drive numbers up again, and another wave is expected in the summer or fall.

"I would couple the comment that we're in a good place right now — seeing this decline in omicron cases — with we're gonna have to ramp up restrictions and do so quickly as cases come back, especially if more virulent, more deadly variants appear in our future."

According to Otto, B.C. saw an uptick in cases after it lifted its provincewide mask mandate on March 11. Unlike Alberta, which kept transit masking in place after removing the requirement in other public settings, B.C. eliminated its face-covering rules at the same time.

"After the mask mandate was lifted, we did see a rise in cases. But it's very hard to know how much of that was due to the lifting of the mask mandate and how much of it was due to the spread of the BA.2 variant because both were happening at the same time."

Alberta also saw an increase in cases — which developed into the BA.2 wave — after removing its provincial mask mandate (while keeping the requirement for transit riders) at the beginning of March.

And the province's chief medical officer of health, Dr. Deena Hinshaw, warned recently that Albertans should expect another surge in the fall.

"We need to start thinking of COVID like we think about the weather. Bad weather happens. Waves are going to happen. And when they happen — when we get the indication that subvariants are spreading within our communities — then we put on our mask and we increase our protection levels, just like you would put on your raincoat or bring out your umbrella," said Otto.

She recommends people wear masks in indoor public places, regardless of the rules in place.

Concern for high-risk Albertans

Dr. Daniel Gregson, a Calgary-based infectious disease physician, expects Alberta will see a "little bump" in COVID-19 numbers with the removal of the last remaining provincial health measures.

"We're going to see people who have not yet had COVID, get COVID, with no restrictions in place," said Gregson, who agrees measures such as masking are protections that should be "turned on" and "turned off" depending on transmission rates.

"We can't be masking forever. At some point in time, they had to come off. I think the messaging could have been delivered to at least give the public the impression that at some point in time these restrictions might be back on."

According to Gregson, removing the legal requirement to isolate could lead to more people showing up at work when they're sick.

"I think that puts people in a difficult position when their employer wants them to come to work. Without a mandate, then then you're feeling pressure to go to work," he said.

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Gregson's key concern now is vulnerable Albertans.

"This is very difficult for the immunocompromised patients who are at high risk of being admitted [to hospital], and they should really be looking at if they get infected, what should they be doing?" 

According to Gregson, that includes finding out if you're eligible for the antiviral, Paxlovid, before you get sick.

And  he said very high-risk Albertans, including some transplant and cancer patients, should talk to their doctors about getting treated with the preventative therapy Evusheld, which was recently made available in the province.

The list of eligibility criteria and instructions on how to access these drugs, can be found here.

Masking requirements in health-care facilities, including hospitals and care homes, are now handled as internal Alberta Health Services' policy, and the health authority said this week those rules remain in place.