Approximately 40 anti-vaccine protesters congregated in front of the Pelham home of Dr. Mustafa Hirji, Niagara’s Acting Medical Officer of Health, last Saturday, January 8. This was the third such protest at Hirji’s residence since just before Christmas. Niagara Regional Police allowed the protesters to agitate for about an hour before dispersing the crowd. Protesters demanded that Rebecca Hahn, who ran for the People’s Party of Canada in the last federal election, be allowed to speak before Niagara Regional Council regarding her concerns about Covid-19 vaccinations. Epithets were hurled at Hirji for his restrictive health directives and support for inoculating children, and at Prime Minister Justin Trudeau for his recent alleged characterizations of anti-vaxxers as women-haters, racists, and science-deniers. DON RICKERS

Hirji re-emphasizes vaccination boosters, social distancing, masking

Omicron has us in its grasp, and “it may well be here for a very long time,” according to Niagara’s Acting Medical Officer of Health, Dr. M. Mustafa Hirji.

The Region announced that there were 361 new cases on Thursday, Jan. 13, for a total active case count of 5,599, a figure it cautioned was an “underestimate of the true number of individuals in Niagara with COVID-19.”

As of Thursday, there were 179 active cases in Pelham, 579 in Welland, 271 in Thorold, and 38 in Wainfleet. Of Niagara’s 12 municipalities, Grimsby had the highest per capita rate of infection, at 131.6 cases per 10,000 population.

“My best guess is that this will go on for a couple of months, and then in March the case load will fall, but not completely disappear,” he told the Voice. “By then, most people who have wanted a booster dose will have had it. Those who didn’t want the booster dose, or didn’t want to be vaccinated at all, will probably be infected, unfortunately. Hopefully, we’ll come out of it okay. Between the vaccinated and those infected, there should be enough immunity out there that it won’t be able to surge and cause huge numbers of illness.”

Hirji believes we will likely see a similar situation to that which exist most winters with influenza, “where you have a wave of cases, and then the spread falls back down.”

Omicron is the primary virus mutation at play currently, having eclipsed the Delta strain. There is a new French variant on the horizon, but Hirji is not concerned with it at the moment.

“Every time the virus spreads, it mutates a little bit,” he said. “Most of these mutations basically amount to nothing. When we see a few people catching a new variant, it is classified as a ‘variant of monitoring’ or a ‘variant of interest.’ If the new strain spreads and becomes a real threat, it is reclassified as a ‘variant of concern.’ Alpha, Delta, and Omicron are all variants of concern. The new variant in France is really just a split off another variant that has been monitored since September.”

Hirji is quite clear about the necessity of booster shots.

“The province announced last week that a fourth shot will be available to those in long term care homes and retirement homes, and seniors generally, because that’s the highest risk group to get severe illness. We’ll have to see if we go down the road of a fourth booster for everybody else. But for now, the majority of our population needs to get that third dose as their booster.”

Asked about the introduction of the latest vaccine called Novavax, Hirji noted that the viral vector vaccines such as Astra Zeneca and Johnson and Johnson/Janssen have been effective tools in the fight, as have the mRNA vaccines such as Pfizer and Moderna. Novavax is a recombinant nanoparticle protein vaccine, which is based on the same technology used in the Flublok influenza vaccine, and is similar to other vaccines that have been around for a long time, such as the one used to treat Hepatitis-B.

“I think what’s been really great about the mRNA vaccines is that they were able to be developed really quickly, and they have turned out to be very safe and very effective. The Novovax will be one more vaccine that we’ll have available. The clinical trials are still being finalized, and the early data seems to show it holds up well against the Delta variant. The real test will be how good it is against Omicron.”

I think what’s been really great about the mRNA vaccines is that they were able to be developed really quickly, and they have turned out to be very safe and very effective

Pfizer announced recently that it is in the process of developing a vaccine aimed specifically at Omicron, and is hopeful that it will be available in March. Niagara Health has reported that most people hospitalized or placed in intensive care in recent days were previously vaccinated, evidence of the challenge Omicron represents to the healthcare system.

Although hospital admissions are at an all-time high, Hirji said the number of patients in intensive care is half of what it was at its peak. He credits vaccines with preventing an escalation in intensive care admissions.

There has been a recent and huge upswing in Covid-19 child hospitalizations in the U.S., where the overall immunization rates are far below Canada’s level (62 percent fully vaccinated in the U.S., 78 percent in Canada). Hirji noted that both Pfizer and Moderna are working on vaccines for young children, but the early clinical trials have produced results that were unsatisfactory.

“It’s going to take a bit longer for us to get a vaccine for children under age five,” he said, “but I’m more concerned about those five and older, children who are school-age. They’re around a lot of other people, and that’s where we generally see the infection. I’m disappointed that only about 40 percent of parents who have children age five to 11 have gotten their kids vaccinated. Hopefully we will see that number go up in the coming weeks.”

Because Omicron spreads so easily, all the measures in place to control the infection have become less effective, said Hirji. He stressed that masking is still important, and that it is critical that the mask be a good fit, with no gaps or spaces which could let the virus enter a person’s mouth or nose.

“Cloth masks might be okay if they have three layers, but it’s hard to know, because cloth masks are not a regulated product,” said Hirji. “Medical-grade masks offer reliable protection, and at the top end, N95 or KN95 masks provide the best filtration possible.”

Hand washing and physical distancing remain “super important,” said Hirji.

After demonstrators appeared twice at Hirji’s Pelham home during the holidays, voicing their displeasure at his Covid-19 health policies and social restrictions, politicians and Niagara residents were quick to leap to Hirji’s defense.

Demonstrators protest outside the Pelham home of Dr. Mustafa Hirji on Saturday, Jan. 8, 2022. DON RICKERS

“Certainly it was gratifying to get that support,” Hirji said. “Our goal in public health is always to make sure we give people the right information, and, unfortunately, sometimes people don’t like the information we’re giving. And we just have to deal with that. But our goal is, of course, to make sure people stay safe.”

Our goal in public health is always to make sure we give people the right information, and, unfortunately, sometimes people don’t like the information we’re giving

When asked to respond to criticism by anti-vaxxers that only one side of the vaccination story is being told via the media, Hirji said, “I think reporters are smart people. They’re trained to figure out what is the truth, and they’re generally going to be pretty good arbitrators of what is accurate and what isn’t. They investigate all sides, and figure out what is credible.”

Some anti-vaxxers view Covid-19 as little more than a bad flu, and quote a 99 percent survival rate of those afflicted with the disease.

Hirji doesn’t dispute the 99 percent figure.

“Absolutely, there’s a 99 percent survival rate with Covid-19. But one percent can represent a lot of people. If you’re looking at Canada, it’s at least 300,000 who could potentially be dying from this virus.”

Death rates also vary by age, pre-existing conditions, and vaccination status, rendering an overall national average nearly meaningless.

The economic hardships that are a consequence of social restrictions and lockdowns are fully appreciated by Hirji, but his overarching priority is making sure people don’t get sick, and don’t die. He also points out that countries that have best-controlled the pandemic with robust measures have actually fared better economically.

Hospitals across the country have been struggling with staffing shortages due to coronavirus infections among healthcare workers, along with the job burnout which has become commonplace during the pandemic. Niagara Health temporarily closed Fort Erie’s urgent care centre last week, and redeployed personnel to the region’s emergency departments.

Niagara Health also announced the suspension of its mandatory vaccination policy for staff, with over 350 employees currently in self-isolation, and a need to have all available healthy workers reporting for duty.

To contain the spread of Covid-19, the provincial government recently imposed a 50 percent capacity limit on retail shops and malls, closed schools to in-person instruction, and has temporarily closed gyms and large event venues like theatres and museums. Social gatherings are limited to five people indoors and ten outdoors, and indoor dining at restaurants and bars has been banned. These restrictions will remain in place until January 26 at the earliest, and schools will reopen no earlier than January 17.

Some 25,000 people in the region are known to have been infected since the pandemic’s onset. However, due to the recent surge in cases, limited availability of testing, and changes to case and contact management practices, case counts are an underestimate of the true number of individuals in Niagara with the coronavirus.

The province’s online portal for booking booster shots is https://covid-19.ontario.ca/book-vaccine