What Canada can learn from Yukon's current wave of COVID-19

Is Yukon's wave of COVID-19 cases a cautionary tale? Or a success story?

An epidemiologist who has been watching the territory's outbreak closely from his home in Ontario says the answer lies somewhere in the middle. 

Dr. David Fisman, a professor with the University of Toronto, says that given Yukon's high vaccination rate and strong public health track record, its current wave contains warnings for other areas of the country about where societal vulnerabilities lie. 

Simultaneously, he says Yukon remains an "inspiration" for the rest of Canada. 

The territory reported six new cases of the virus on Friday, bringing the total active case number to 116.

The gamma variant-fuelled outbreak that has swept through Yukon was declared in mid-June, and has been linked back to a single party in Whitehorse. 

As of June 6, the territory had recorded just 87 cases — a number which has now risen to 461. In terms of positive cases, it's the largest outbreak the North has experienced. 

Fisman spoke with host Elyn Jones on CBC Radio's Yukon Morning on Monday. Their conversation has been edited for length and clarity.  

From a distance, what does Yukon's current wave look like?

Something that's been really striking is that the northern territories and Atlantic provinces have really run circles around the country as a whole, in terms of their public health management.

Yukon hasn't just led the way in terms of public health measures, I think it also leads all provinces and territories in terms of vaccine uptake. 

The fact that you can have a resurgence at that high a level of vaccination is really a bit of a warning for those of us to the south of you who have been slightly less good at controlling this pandemic even before we had vaccines.

The difficulty comes from the fact that these variants have really moved the goalposts on what we need to do in terms of achieving herd immunity. The original COVID strain had much lower transmissibility than the gamma variant.

We really need very high levels of vaccination for this not to bother us at all. 

The other point in Yukon is... that the infections there are very heavily concentrated in unvaccinated individuals. So that in a sense is encouraging, because that says, well, if you don't want to deal with this anymore, here's your golden key out of the pandemic — get vaccinated. 

What does it mean for the rest of Canada, where people are reopening and governments are lifting restrictions?

I think there's a tendency to turn all the dials in one direction at the same time, and I think that probably is a bit rash. 

We're a very lucky country in terms of availability of vaccines… but because not everybody is vaccinated, and because the new strains are more transmissible, and because we can't vaccinate kids yet... that means we can reopen but we still need to use some of our non-vaccination tools to keep transmission down.

Especially in a couple of vulnerable settings, like long-term care homes, jails and prisons, shelters, and schools as we move into the fall. 

Some of those simple tools are masks, better ventilation, better use of testing, better use of contact tracing. 

And then, because we're so highly vaccinated, that makes the virus less infectious… it really acts like a firebreak on infection. 

And with this current wave, we're seeing it move through our vulnerable population. Has that played out in other parts of Canada too?

It absolutely has. 

[In Thunder Bay, Ontario] you had a real surge of cases that started in homeless shelters, and then hit jails and from there moved to schools and into the wider community. 

Dr. Tedros [Adhanom] from [the World Health Organization] has said that none of us are safe until all of us are safe. I think the idea there is, you have to focus on vulnerable settings.

You mentioned schools. How concerned are you about schools and the possibility of COVID spreading there?

We desperately need to get kids back to normal school. But we also need to acknowledge that schools can accelerate COVID transmission. 

And then it can move out into the wider community. And you're seeing that in the UK right now with the delta variant. Even though they are highly vaccinated, if you have enough transmission it will find the unvaccinated. 

There's a lot of great information on how to keep schools safe. The U.S. [Centers for Disease Control and Prevention] has shown us that improving ventilation and using air cleaners like HEPA filters combined with masks can reduce transmission in schools by about 80 per cent. 

Would you say Yukon's a good news story? Or a cautionary tale?

It's sort of both. 

You can't see the illnesses and deaths that didn't occur in Yukon because of your excellent public health management and high rates of vaccination. 

So that's really blunted the impact of this, and that's a good news story, but that's a hard good news story to tell because the effects of vaccines and good public health management are invisible. 

It's a cautionary tale because we can look at Yukon as a place within Canada that's really outperformed the country as a whole but still shows us that vulnerability exists.

Overall, the territory has been an inspiration to the country. To me, over the long view, you're very fortunate and there's a lot to admire and a lot to celebrate.