Infectious disease expert on returning to in-person work, getting COVID more than once

With few public health restrictions in place and a record number of people dying from COVID-19 it can be a confusing time to navigate the pandemic.

But infectious disease specialist Dr. Lisa Barrett says Nova Scotians should continue to practise the lessons they've learned during the last two years. 

This Mother's Day, for example, Barrett recommends testing before you visit vulnerable friends and family. If you're going to see someone who's older, visit them before you go to a bigger gathering with multiple people, she says.

Barrett spoke with CBC Radio Information Morning host Portia Clark about how people can navigate this phase of the pandemic, and what could be on the horizon. Their conversation has been edited for length and clarity.

You can listen to the full interview here:

In light of the infections and deaths, do you think people are still trusting the messages coming from health officials? 

That's a good question, but I think we need to make sure the messages are right for people to hear, as well. Deaths are important and not inevitable, we showed that early in the pandemic. If we take a look back through the publicly available data, 65 per cent of our deaths for the entire pandemic have happened since December. In the last three weeks since we've changed some other important policy, [there have been] 51 deaths. That's 25 per cent or so of our Omicron deaths have happened in the last three weeks ... so I think it's important for people to know that that death rate is not insignificant. And as our cases hopefully are going to continue to go down, which is good, it's important for people to recognize that those policies and their behaviours actually made a difference early on. 

Two-hundred-and-two people have died since Dec. 8 between the ages of 10 and 100, though the average age is 80. When you hear people saying that it's unfortunate but not surprising, what do you make of that? 

I don't assume that as you get older that you become the vulnerable group that we, as a society, are pretty certain are going to die from infectious diseases. It's true that that will often be a cause of death as you get older, but it's not inevitable and certainly not in a pandemic. 

We can do more as we go forward. If we don't have the policy part in place around public masking and capacity limits, then we can do things at a personal level that can help us protect our vulnerable … Vaccination is the foundation, absolutely, but then we need to layer on some other things. Don't expect me to stop saying that at the end of May. For quite some time and into the fall, [we] just need to structure things differently to protect our vulnerable as we get out there. 

Right now, a lot of employers are asking their employees to return to the office. With death rates from COVID being at their highest, how do you help people make sense of that?

We do know for folks who are medically well, that vaccines are a great protective factor against both hospitalization and death, and those rates are exceptionally high — for death, 90 per cent reduction in terms of your relative risk, so feel good about that part. 

But also ... it's the people around you that you don't know about who are vulnerable. So when you go back to your workplaces, don't do everything all the time. Do things in smaller groups, do hybrids for a while that are a combination of in person and virtual. Wear masks if you're going to be around folks.

It's important to remember if people are sick, they have to have the resources to stay home. And as we go forward … and the weather gets warmer, I hope people use better ventilation that's either natural or added to your workplace. Those are all great ways to start to get people together a little more safely. 

A lot of us have had COVID, yourself included, and we are hearing that people are getting it twice and even three times. In most cases, does the severity of the illness decrease with each infection? 

So your immune system is pretty amazing, but it also has a pretty big foe in this virus right now because the virus is still trying on different outfits, if you will, in terms of how severe it is and what it's doing. Generally, there have been some signals that people who are reinfected, who are vaccinated in the background … may get a milder disease. But that's not always the case, particularly for people at high risk. So the answer is: we're still sorting it out ... But don't bank on the reinfection being the best. Your immune system's doing its best, but it's going to take a couple of years for the virus and immune system relationship to settle out, if you will. 

And in the big picture, is this virus petering out or should we be bracing for another variant? 

Globally, we're trying to really keep track of what's happening and try to predict. It's a very tough time to predict, we've got to do lots of testing and what we call surveillance and keep track of the new variants. Am I certain we're not going to get one? No. But as we go further and further along, the risk of that reduces. We just have to be very careful and mindful that we're watching both people and the animal reservoirs out there where this virus can hide out, and make sure we've put a lot of effort into that. And don't forget, we've got to learn the lessons of this pandemic better than we did others.