St. Catharines Site, Niagara Health System. SUPPLIED

Dr. Mustafa Hirji, Niagara’s Acting Medical Officer of Health, and his provincial counterpart, Keiran Moore, have divergent priorities.

Moore has gone on record as saying that a broad mask mandate is not in the cards for the foreseeable future, despite a recent sixth wave of Covid-19 in the province that is generating 100,000 infections daily, and is not expected to subside until May.

Hirji thinks that it is still a prudent personal decision to cover up.

“Infections have risen of late, but I don’t think we need to go to a stage where we’re closing businesses or putting in place capacity limits,” he said. “Masking is a simple thing we can all do to make sure we keep those around us safe, and make sure we limit the harm from this latest wave.”

Dr. Mustafa Hirji. SUPPLIED

Niagara elementary school teachers have reported that some classes were experiencing absentee rates of more than 20 percent.

“We’ve definitely seen a lot of spread of infection in schools,” said Hirji. “And it was, frankly, predictable, because after the March Break, the provinces basically took away all the protections they had for children, which coincided with the new wave. I would really recommend that schools, and the rest of community, bring back masking policies, to make sure that they can keep the school environment as safe as possible.”

Hirji said that the Omicron BA.2 variant is now responsible for about half the infections in the region.

“The Omicron variants in general have been less dangerous than some of those previous variants,” he said, “but even if we’re talking a 30 to 40 percent reduction, that’s still, unfortunately, a lot of people who are going to be hospitalized.”

Dealing with Covid-19 in the long term is a prospect we are all going to have to come to grips with, said Hirji. And paid sick days is one of the tools that he would like to see implemented for all employees.

“The virus is not going to go away,” he said. “We are going to see periodic waves that are going to cause people to be hospitalized, with some getting severely ill. New variants will likely keep coming. We need to plan in a fashion that won’t harm our economy and social life which we unfortunately experienced from time to time over the last two years. We must build a culture where if we’re sick with illness, we stay home and make sure we’re not out and spreading it to other people. For those who are able to work from home, it’s not a big deal. But for some people, particularly those who are in lower-income service sector jobs, they often don’t have that kind of luxury. They need to show up to work, because they have bills to pay. So having paid sick days is a way to make sure that they can do the right thing and stay home.”

We must build a culture where if we’re sick with illness, we stay home and make sure we’re not out and spreading it to other people

Hirji is advocating that people consider a fourth dose, or second booster.

“Currently those age 60 to 79 are eligible, but I think it’s more of an option for them. The group that really does need to absolutely get it right away are those 80 and over.”

Are we looking at additional boosters down the road?

“I think it’s too early to say if we’re going to have a fifth dose,” he said. “We’ll have to see what happens. I think there’s a reasonable chance that we will see some sort of booster dose in the fall. I’m expecting, unfortunately, that we’re going to have another wave of Covid-19 in the fall.”

The new, protein-based Novavax vaccine, which was approved by Health Canada in February, is now available in Niagara for those with medical conditions which preclude mRNA vaccines made by Pfizer and Moderna.

“We’re holding clinics now with Novavax, and will be expanding the availability as more people sign up for it,” said Hirji. “Novavax vaccinations require an appointment, because we don’t have it routinely available at all of our clinics. Some had allergic reactions to the mRNA vaccines, so this is now another choice for them to be able to get an additional dose or booster.”

He is skeptical that the mere presence of Novavax will prompt hoards of the unvaccinated to get the jab.

“I don’t think it’s going to make a huge difference, because there have been four different vaccine options already. People who haven’t yet signed up are probably unlikely to sign up. That being said, we’ve had over one hundred people just recently who did sign up for Novavax, so we’ll get a few more people vaccinated for sure. And we’re happy to do that.”

Health Canada has confirmed six cases of XE, the latest version of Omicron, said to be the most transmissible variant yet, according to the World Health Organization (WHO). The BA.2 Omicron strain is now dominant in about 70 countries, and makes up over 90 percent of infection cases worldwide. Vaccination plus a booster shot appear to offer strong protection against severe illness and death regarding both Omicron BA. 1 and BA.2.

The WHO has detected a small number of cases of BA. 4 and BA. 5 strains in a few countries.

New variants will continue to appear, says the Public Health Agency of Canada, which notes that all viruses, including Covid-19, have mutations, most of which do not cause severe illness.

PCR molecular tests, which have a higher accuracy rate than the readily-available rapid tests, are now being provided to seniors and the immunocompromised, as is the anti-viral medication, Paxlovid.

“Up until now, it’s only been a very limited number of people who qualified for PCR tests,” said Hirji, “including health care workers, those who live in congregate settings, and those at high risk for outbreaks. The rapid tests are about 70 to 80 percent accurate, so not perfect, but still quite good. One thing I have observed with the rapid test is that, as soon as someone becomes sick, the rapid test may come back negative, but a day or two later, it becomes positive. So I encourage people, if they do get sick, and they get a negative test, to repeat the test a day or two later and see what it shows.”