Infectious disease expert says Nova Scotia's reopening plan makes sense

Nearly two years into the pandemic, Dr. Joanne Langley says Nova Scotians have learned a lot about how COVID-19 spreads — and how to keep themselves safe.

It's why the pediatric infectious disease physician at the IWK Health Centre in Halifax says it makes sense to begin cautiously easing restrictions.

Nova Scotia began dropping pandemic restrictions in a three-step reopening plan that began Monday.

"I think at this point, we have enough experience to try reducing restrictions to some extent, but keeping aware of what we might need to do based on what happens to the disease transmission," Langley told CBC Radio's Mainstreet on Wednesday. 

Her interview with guest host Preston Mulligan has been edited and condensed for clarity.

Listen to the full interview here: 

Do you have any reservations at all about our current path to reopening? 

I don't think going into the third year of a pandemic, that has taken such a toll on humanity, that anyone is feeling relaxed or not worried at all. We don't know what the path ahead will look like, and so we all have a bit of trepidation about it doesn't mean we can't act.

We saw a record number of deaths reported on Monday. Explain to us how it makes sense, given what we're seeing — the number of cases, the number of Nova Scotians dying — why we are reopening?

Of course any loss of life is very shaking to us all and a cause of great sadness ... When public health decides to change its guidance or its restrictions, it's looking at many different measures of how well the population as a whole is doing.  They're looking at how many people are vaccinated. What is the transmissibility? How much do people know now, two years going in, about keeping themselves safe in a way that doesn't require you to have laws that make people try to keep themselves safe? We have a very experienced population now.

The transmissibility rate is still pretty high, even though the large majority of us are double vaccinated. I feel like I know one or two people a day who get infected or become close contacts.

The natural history of any infection is very important in determining how restrictive the measures need to be. So if we had an outbreak of the sniffles three years ago, obviously we wouldn't have put in a pandemic call out, we wouldn't have enacted all those measures. Now we have an infection that if you are vaccinated, the likelihood of you becoming seriously ill is greatly reduced. If you want to add on protective measures for yourself, you might avoid people who are sick … you wouldn't want your newborn to be exposed to people who have sniffles, or are ill. You can avoid very crowded places, so there are things that we can do now that will reduce our risk. It's not like we were before where we had nothing to protect us.

Our human bodies are covered in bacteria and viruses, only some of them ever make us sick. So we're not looking as an end point that we would never have anyone come into exposure with the SARS-CoV-2 virus. We're planning on having people with enough immunity, or other measures besides vaccines for some people, that would prevent us from getting seriously ill.

How can we be certain that there won't be another, more dangerous, more transmissible virus around the corner just like Omicron?

I guess the short answer is that we can't be sure. This idea of emerging infectious diseases has been a topic of research in the last, I'd say, probably four or five decades when we saw HIV emerge, hantavirus in the 80s and so on. All these new diseases. Some were brand new, but some were re-emerging ... We need to always have a local, a national and a global surveillance system to watch for these viruses and bacteria that emerge. And we need to be aware of the factors that increase risk and do something about them, which includes a lot of global approaches. 

We've heard that the virus can be less severe for most children, but last week Nova Scotia also reported the first death of a child related to COVID-19. What are we to make of that? 

As with an adult, a death of a child, whether it's directly due to what we normally think of a COVID type of illness with respiratory illness, or they happen to have it at the time, regardless, any death is very sad for us. It's a loss from our community.

We know from the United States, and other places in the world, that children can get very serious illness, not only acute illness, but the longer-term sequelae, the multi-system inflammatory syndrome. They can also get the same kind of blood clotting disorders that adults get, and we're just starting to learn about long COVID in children. So it's important for children to benefit from the protection of vaccines as much as it is for adults. Even though from a population-wide perspective, a fewer percentage will get ill, those who get ill, can become very ill.