Ready for action: gym space at Pelham's community centre set up for Covid-19 jabs in April 2021. SUPPLIED

Hirji urges flu, booster shots, masking indoors

Dr. Mustafa Hirji, Niagara Region’s Acting Medical Officer of Health, appreciates that most people are tired of hearing about the Covid-19 virus, but ignoring booster shots, and other preventative measures such as masking in public places, is a mistake, he cautioned.

On October 19, Hirji spoke at a Niagara District Council of Women meeting via Zoom, on the topic Covid-19 and its variants. The virus is again gaining ground in Niagara, and has become the third leading cause of death in Canada, behind only cancer and heart disease.

“Covid-19 spreads like other respiratory illnesses, such as influenza and pneumonia,” he said. “We need to clean our air with ventilation and filtration systems indoors, so that what we’re breathing won’t be passing infection on to us. The easiest thing we can do is to have as many as possible activities outdoors. We’ve had lots of success having outdoor patios at restaurants the last couple of summers, and I think we should absolutely double down on this.”

The pandemic has demonstrated that infection rates spike in January because of seasonal social engagements in December around Christmas time, which significantly spread the virus, and indeed have necessitated lockdowns, said Hirji. However, he said that this past August was the deadliest month of the pandemic in Niagara since February 2021, and that 2022 could set a record for deaths from the virus across Canada.

Infections have increased during the fall wave, with some 800 active cases reported by Niagara Public Health. Covid-19 has claimed the lives of 610 Niagara residents since the pandemic was declared.

Using a selection of charts to underscore his analysis of the data by age group, Hirji defended the strict posture he has advocated in handling the pandemic.

“We’ve absolutely saved lives of people, compared to what we saw in the United States and the United Kingdom, where they didn’t address the pandemic nearly as rigorously as us,” he said. “I think this is a clear illustration that people’s lives were saved by the actions we took here in Canada. The outcome was over 1500 people are alive in our community because we took those difficult steps. And I think we should all remember that when we look back at those hard years, that the sacrifices weren’t for naught. It made a real impact.”

We’ve absolutely saved lives of people, compared to what we saw in the United States and the United Kingdom, where they didn’t address the pandemic nearly as rigorously as us

Hirji said that the pandemic response in Canada was “unified,” unlike in the United States, where the pandemic became a heated political issue.

“In Canada, people on both sides of the political spectrum, by and large, got vaccinated and took the pandemic seriously,” he said. “Because we have local public health systems here in Canada, we were able to customize the response somewhat to address the local risks.”

Forget about herd immunity as a salvation at this point, said Hirji, because the virus is mutating so quickly that vaccines become less effective. Currently, the infection prevention rate of vaccines is between 20 and 40 percent.

“But the point to highlight is that over 90 percent of hospitalizations and deaths are still prevented by the boosters,” said Hirji. “I think almost everybody agrees vaccinations absolutely have to be part of what we do. If you haven’t gotten a booster dose this fall, if you’re age 12 or older, absolutely go out and get it, since it’s your best protection for the coming wave that we’re going to see this fall, and is protection against those new variants that are arriving.”

Hirji said that vaccines are going to continue to be part of a baseline level of protection, but that a societal adaptation is required, involving masking in congested areas, moving events outdoors, staying home when sick, and providing sick leave for all, in order to minimize the negative impacts of viral mutations and infections.

Asked which brand of vaccine booster is “best,” Hirji responded that “the more important message is that it doesn’t matter which one you get. Both Moderna and Pfizer have come out with a booster dose that addresses the Omicron variant. I chose to get the Moderna shot, because during the pandemic it has performed a little bit better, but the Pfizer dose is absolutely a good choice as well.”

I chose to get the Moderna shot, because during the pandemic it has performed a little bit better, but the Pfizer dose is absolutely a good choice as well

As far as possible government mandates around masking and future lockdowns, Hirji said “the sense I get is that governments around the world are tired of dealing with the pandemic and all its costs, and they’re hoping that if they don’t do anything, we’ll kind of muddle through, and make out not too bad. My view is that we’re seeing a society that is less healthy, less equal. Our healthcare system is less sustainable, and we are less economically prosperous because we’re still allowing Covid-19 to spread. I don’t know why government isn’t taking more action.”

Seniors and those with compromised immune systems are most at risk from Covid-19, and Hirji was asked whether the oral antiviral medication Paxlovid should be considered for use by this segment of the population.

“Paxlovid can have side effects like muscle aches and fatigue, and can be quite harmful to the liver and kidneys,” he said. “Your doctor has to do some blood testing before prescribing this medication. But for those at higher risk, it absolutely does prevent people from dying.”

Brock University immunologist and Associate Professor of Health Sciences Adam MacNeil, commenting in a recent Brock News article, supported Hirji’s perspective on containing viruses. MacNeil advocates that people be vaccinated against Covid-19, and also get a flu shot, explaining that the immune system recognizes the influenza and SARS-CoV-2 viruses as being two distinct entities.

“Flu and Covid vaccines do not overlap, and people should strongly consider getting both, especially if they have vulnerable immune systems,” said MacNeil. The latest Covid vaccine is “bivalent,” which means the booster targets the original strain plus subvariants arising from the Omicron strain.

Unlike the flu, Covid-19 can cause problems in tissues and organs that may persist after infection—“long Covid”—and can cause inflammation of the blood vessels, affecting the brain and heart, he said.

“To give yourself the best possible protection against the expected surge in influenza and SARS-CoV-2 this fall, do yourself and your community a favour, and get both vaccines as soon as you are eligible, wear a well-fitting N95 respirator when in crowded indoor locations or when ventilation and air filtration is poor, and practice distancing,” MacNeil said.