'Living with COVID' plan shifts Sask. pandemic response as hospitalizations rise

The Saskatchewan government's pandemic response has again evolved to "living with COVID," while hospitals face increasing pressure and doctors worry about the timing of policy changes.

On Thursday, the government announced its self-isolation policy was changing for people who test positive to five days regardless of vaccination status. It also removed the requirement for unvaccinated people to self-isolate if they are a close contact.

Saskatchewan is the first province to make both changes, British Columbia made isolation changes last week, but still requires unvaccinated people to isolate for 10 days following a positive test. B.C. also said parents no longer have to inform schools if their child tests positive.

"For most people the five days are sufficient to become non-infectious, and continue to restart work and school in a safe manner," said Dr. Saqib Shahab, the provincial chief medical health officer.

More changes expected

Comments by Premier Scott Moe this week suggest more public health policy changes are on the way.

On Wednesday, Moe told Rawlco Radio, that requiring proof of vaccination had "for the most part runs its course."

"It increased our vaccination rates tremendously, but I think we're getting to a point now where those that are not vaccinated likely aren't going to get vaccinated," Moe said.

The Provincial Emergency Operations Centre held a media conference later that morning in which the spokesperson said the premier's comments would not be addressed during the call, however many reporters ignored that request and asked Shahab for his opinion.

"For the short term, I think we still need to stay the course, because even though we are cresting and starting to come down, if we relax everything right away we will just rebound and that would not be good at all," Shahab said.

About 79 per cent of people over the age of five have two doses of the vaccine in Saskatchewan, making it the second worst province after Alberta, with about 77.5 per cent. 

However, Saskatchewan did offer third doses early on, and out of seven provinces (information for Quebec, Nova Scotia, Newfoundland and Labrador wasn't available) Saskatchewan is the second best in terms of third-dose coverage at 44 per cent, after Ontario with about 46 per cent. But, Shahab said this week that the pace of third doses has slowed.

Saskatchewan's public health orders, which include mandatory masking, proof of vaccination and mandates for government workers expire on Feb. 28.

Shahab said discussions about what happens after then are ongoing and that those announcements would be made by the government.

Moe's hint that proof of vaccination policy could be the first to go is not new. In December, during a year-end interview with CBC Moe delivered a similar message:

"If we feel that our vaccination levels have plateaued and the proof of vaccination policy has run its course and encouraged as many to get vaccinated that will, there may be a decision at some point that will have to be made around removing that policy, as it simply isn't increasing vaccination levels anymore."

As for provincial government vaccination mandates, Zak Vescera of the Saskatoon Star-Phoenix reported this week, that the Saskatchewan Health Authority has yet to discipline any employees who have not complied with the policy. Derek Miller, the SHA's interim chief operating officer, could not give a number when asked on Wednesday by reporters how many employees had violated the vaccination policy.

On Monday, Premier Moe called a federal policy that requires truck drivers entering Canada from the United States to be fully vaccinated "unnecessary."

SHA calls situation 'emergency'

The isolation policy changes announced Thursday come at a time when the more transmissible Omicron variant has resulted in a steady increase in the number of patients inside Saskatchewan hospitals.

Shahab said this week that hospitalizations will continue to rise through February.

"Decisions will be made but that may not align with what the arc would be for hospitalizations, which may continue to rise for several weeks longer, even though case numbers are declining."

Saskatchewan's Health Minister Paul Merriman said Thursday, even though a lot of people are "contracting COVID-19 that is not transitioning into larger numbers than we saw with the Delta wave in our hospital."

"We are very optimistic that we are in a very, very good spot," he said, adding the government's Omicron responses will "evolve."

In an SHA physician's town hall on Thursday night, a slide said the current slope of hospitalizations is seeing an "exponential increase," which is "not sustainable" and called the current situation an "emergency."

It said the increasing number of patients and staff pressures due to the virus would create the "toughest wave yet."

Omicron hospitalizations related to COVID-19 will soon pass records set during the Delta wave last October.

Merriman and Miller said pressure was being felt in Regina and Saskatoon hospitals but neither offered specifics on how many patients would need to be moved out of the major centres. Merriman said patient transfers were underway.

As of Friday, there are 342 COVID-19 related patients in Saskatchewan hospitals. On Oct. 6, 356 patients were in hospital with COVID-19 including 76 ICU patients.

Opposition Leader Ryan Meili said Thursday, the provincial government has only relaxed measures as Omicron has spread "over and over again."

Nationally, Omicron cases have peaked, Dr. Theresa Tam, Canada's chief public health officer, said on Friday.

'Manage' COVID-19 like other respiratory illness: Shahab

On Thursday, Shahab said the provincial strategy to manage the pandemic would be similar to how it handles respiratory viruses like influenza.

"COVID-19 will be monitored and managed similarly to other respiratory viruses, preserve public health and health-care capacity for preventing and treating severe cases," read a slide presented by Shahab, comparing the plan to how public health approached the 2009 H1N1 pandemic.

The H1N1 pandemic resulted in 15 deaths in Saskatchewan. So far in January, 32 deaths related to COVID-19 have been reported by the province.

Shahab said the public health order revisions support "a self-management" approach to COVID-19.

"Changes that support a self-management approach need to balance any risk of community transmission with continuity for families, individuals, and businesses," another slide read.

"(Omicron) is so transmissible that many of us who were able to dodge COVID prior will get exposed. And for most people, especially those who are fully vaccinated and boosted, it is proving to be a mild, self-limited illness for five to seven days."

Shahab said the changes are "based on evolving science" but also the reality that having so many people isolate "creates a lot of pressure on the  business community and the ability of students to be in-class learning."

Some Saskatchewan doctors are expressing concerns about the pressures facing the health-care system.

On Thursday, Saskatchewan infectious disease physician Dr. Alexander Wong said policy changes regarding isolation and school notification were coming too soon and would not reduce spread.

"We sort of have to figure out what the new normal will look like, every jurisdiction in the world is thinking about this and what it's going to look like … that being said, the conflict for me is that we're right in the middle of our Omicron surge right now."

University of Saskatchewan virologist Angela Rasmussen shared the sentiment.

"I just think it's really much too early to be relaxing precautions [of] isolation and on notification of close contacts," she told CBC's The Morning Edition.

Dr. Isaac Bogoch, an infectious diseases specialist with Toronto General Hospital, said Canada is not at a point where the virus is endemic.

"Here's what [endemic] doesn't mean: It doesn't mean where we're at right now. We're seeing health-care systems stretched and society significantly impacted by the virus. That's not endemic. That's still pandemic."