N.B. move to monthly COVID-19 updates 'wrong thing to do,' says epidemiologist

An infection control epidemiologist says he disagrees with New Brunswick's decision to cut back its COVID-19 updates to monthly instead of weekly, as of this week.

Colin Furness, an assistant professor at the University of Toronto, who has followed the progression of the pandemic in New Brunswick, says the move "reflects an attitude that COVID is a seasonal virus, a respiratory virus, and not a particularly serious health concern."

"In my estimation COVID is not seasonal, it's not a respiratory virus, and it's extremely concerning," he said.

"So I think … the decision is consistent with their logic. I just think that their logic is wrong."

Tuesday marked the final weekly COVIDWatch report before New Brunswick switches to monthly updates. The province recorded four more COVID deaths, 11 hospitalizations because of the virus, 78 new lab-confirmed cases and a positivity rate of 11 per cent.

The new Omicron subvariant that has caused a surge in India and has been detected in at least 33 countries, has now also spread to New Brunswick. Two cases of XBB.1.16 have been confirmed in the province to date, according to the Department of Health.

COVID-19 activity "continues to be an ongoing concern," Dr. Jennifer Russell, New Brunswick's chief medical officer of health, has said. But case numbers, hospitalizations and deaths have been "relatively stable" since January.

The switch to monthly COVID updates is "to ensure consistency in [the province's] reporting on respiratory illnesses," such as influenza, Russell has said.

Not necessarily seasonal and not 'only' respiratory

Furness contends treating COVID like the flu, with a "silent assumption" that it's seasonal, is "dangerous."

It may be logical to expect COVID numbers will be higher in the fall and winter, when people are gathered indoors more, with windows and doors closed, he said. That's when all viruses tend to flourish, including common colds, which are not actually very contagious and require close indoor contact to spread.

However, COVID is "far more contagious" and doesn't require ideal conditions to multiply.

So to assume COVID isn't "worth paying attention to" during the summer months is "foolish," said Furness.

The change in reporting becomes "self-reinforcing" though, he said. "We're going to conclude that we don't need to measure it and we'll justify that by not having any data to contradict."

Similarly, Furness challenges the characterization of COVID as being "only" a respiratory virus.

He points to long COVID and the wide range of symptoms it can cause, such as brain fog.

"A data-driven view of COVID is that this is a virus that has efficiently evolved beyond being a respiratory virus to be a highly contagious, systemic virus causing neurological, vascular and organ damage, and immune dysregulation – along with an acute respiratory phase," he said.

Maintaining the view COVID is only a respiratory virus, however, "enables social acceptance that it is not serious and that money does not need to be spent making people safer."

Taking away ability to gauge risks

New Brunswick isn't alone, Furness noted. Other provincial governments have also moved away from keeping the public informed about COVID. "It's all in lockstep with the notion of 'living with COVID,' which is a euphemism for, 'Let's do nothing and see what happens.'"

It's "wrong-minded," according to Furness. He cites low vaccination rates as a consequence of the public not getting the clear message they should.

As of mid-April, only about 13 per cent of New Brunswickers aged five and older have received a COVID-19 vaccine booster dose in the past five months. That's around 100,000 people.

Many people don't think COVID is a significant problem anymore and don't think getting boosted is worthwhile, said Furness.

"If we were doing public health well, we would be concerned about sickness, we would be concerned about disease and about equipping people to gauge risk.

"And we're taking that away. I think that's the wrong thing to do."

'Wastewater doesn't lie'

Furness acknowledges some of that data in the province's COVIDWatch reports has become less valuable over time in terms of helping to gauge risks.

COVID deaths, for example, are often a couple of months after the fact, due to a lag in reporting from date of death to the registration of death, according to the province. There are also fewer PCR (polymerase chain reaction) lab tests being conducted now because they're available only to people with symptoms, where the results would directly influence their treatment, and a referral from a health-care provider is required.

That's why he thinks more wastewater monitoring is needed.

People who are infected shed the virus in their feces in the form of a genetic material called ribonucleic acid, or RNA, before they show symptoms of COVID-19. This can be found in raw sewage and can detect the virus in a community up to 10 days prior to clinical testing, according to the Public Health Agency of Canada.

"Wastewater doesn't lie," said Furness.

It also doesn't rely on people getting tested, and it focuses on "what's coming" instead of what has already happened, he said.

Should track changes in life expectancy, like U.S.

In addition, Furness would like to see New Brunswick and other jurisdictions track changes in population life expectancy. They should look, for example, at rates of heart attacks, strokes and other diseases associated with long COVID.

The United States does keep track of these, he said, and they're going up.

Although Canada looked at the U.S. earlier in the pandemic "with a sense of horror" for "letting [COVID] run wild," the two countries are "more or less the same now" in terms of their attitudes and policies, according to Furness.

"So I think we can look at the U.S. data and say, 'Well, that's almost certainly to some extent what's going on here too.'"

It's difficult to predict what changes new variants like XBB.1.16 might bring, said Furness.

The virus seems to be settling on an evolution track where it's improving its ability to infect and reinfect without becoming more severe, which he suspects will continue.

It could, however, change at any time, he stressed.

Precautions urged

For now, Furness cautions against being "fooled" into thinking COVID isn't a problem by those who want the pandemic to be over and are taking risks.

People should continue to take steps to protect themselves to avoid infection or reinfection, he said. "There's no question the cumulative harm is there. Not for everybody, it's a bit of a Russian roulette game. But you don't want to find out the wrong way or the hard way that that reinfection really, really hurt."

He recommends people stay outside as much as possible this summer, use ventilation indoors, and avoid large crowds. "There's lots of ways to have fun while also minimizing that risk."

The next COVIDWatch report is scheduled to be released on May 30.