‘Highly transmissible’ Omicron BA.2 confirmed cause of surging COVID cases in KFL&A

Heading into this long weekend, there could be an unwanted guest at holiday gatherings: the highly transmissible BA.2 subvariant of Omicron. 

The subvariant is now the dominant circulating strain of COVID-19 in Ontario, Dr. Piotr Oglaza, Medical Officer of Health (MOH) for Kingston, Frontenac, Lennox and Addington (KFL&A) Public Health, confirmed late on Thursday, Apr. 14, 2022. He urged the public to take appropriate precautions to make the holiday weekend a happy one.

“Residents might be making plans to gather with loved ones, and we recognize fully that spending time with those who are close to us is very important for everyone’s mental health,” Oglaza said in his bi-weekly pandemic update to the media. “So, for anyone planning to gather with others, I encourage everyone to assess your risk and the risk of others attending the gathering and make decisions based on that risk assessment.”

The safest option for those gathering is to wear masks in indoor situations where distancing may be difficult. “We have to go back to the previous message and recommendations — especially for those who are at increased risk. Consider keeping the gathering smaller and limiting the number of guests from outside your household,” he said.

Oglaza also suggested people think about gathering outdoors. “The weather is certainly now more suitable for this and that could be a safer option. If the gathering still is intended to take place indoors, keeping windows open and screen doors open will increase the airflow and will also reduce risk,” he explained.

Staying home when sick, even if the symptoms are mild, is extremely important to stop the spread, he emphasized.

“With Omicron, the types of symptoms that people are experiencing might be mild, and they might not really resemble what we thought of COVID before. It could be as [simple as] a sore throat or headache,” the MOH said. “And if someone is symptomatic, even mildly, I strongly encourage them to stay home.” 

Oglaza urged that special caution be taken by the immunocompromised, those with underlying health conditions, older adults, and the unvaccinated, noting, “I know that this is not the news that we wanted to hear before the long weekend, but truly, especially for those most at risk, it is important.”

Omicron BA.2 spreads very easily, and it is starting to have an impact on the number of new hospitalizations for COVID-19 in our region, Oglaza reported. “And what’s significant here is that, in the last 14 days, the number of new hospitalizations has increased significantly; however, what’s important is [that] our active hospitalization numbers remain stable,” he said.

Hospitalized patients in this wave have shorter hospitalization periods than in previous waves, and this seems to be due to the impact of two things, Oglaza said: “One is the potentially lower severity of Omicron, but two is the strong protective effect of vaccination against hospitalization and serious illness.” 

“Our wastewater concentration and percent positivity appear to be stabilizing,” he continued. “However, we will continue to monitor data to see if that trend is then followed by a decrease.”

In terms of infection numbers, “Prevention strategies continue to depend on all of us taking very simple actions to decrease transmission. These actions are not new, we are all accustomed to them, and they still play a significant role in this next wave,” said Oglaza.

Getting vaccinated with the full complement of doses remains Oglaza’s best advice for the prevention of severe illness, “and for those who are 60 years of age and older, that means the fourth dose.”

The province this week announced that antiviral treatments for COVID-19 would be more readily available in pharmacies, and Oglaza stated that “while they’re not a replacement for vaccination, they are available, and they provide an additional margin of safety to protect against severe outcomes for certain highest risk groups of individuals if they become infected.” 

Because antiviral treatment needs to begin within five days of symptom onset, and these different treatment options need to be considered in the context of someone’s health and other medication they might be taking, it is important that those individuals connect with their healthcare provider to determine whether this is the right course of action for them. Oglaza encouraged those who might be more vulnerable, even if they have no symptoms, to consider talking with their physician to plan in advance what treatment might be available or necessary.

Masking was a hot topic of questioning by reporters, who pointed out that some school boards across Ontario have brought back mandatory masking, and that the sixth wave seems to have spiked due to the mixed messaging of lifting the mask mandate.

Oglaza emphasized repeatedly that wearing a mask indoors is still a very good idea in public spaces, but “It is not a sufficient single protective measure on its own … getting vaccinated and getting boosters is key here, and monitoring symptoms and staying home when ill” all continue to be necessary to stop the spread of COVID.

There have been seven COVID-related deaths in as many days reported in KFL&A, continuing a spike in deaths in the region during this sixth wave. Oglaza offered “sincere condolences to all the families who lost loved ones due to COVID-19 throughout this pandemic, but also recently.”

“We know that that age is the … most important predictor of severe outcomes and … the population of 80 years old and over would be most vulnerable. Vaccination [provides them with] very strong protection from their booster doses and second boosters, depending on the setting … and yet still, unfortunately, there might be some circumstances in which those individuals … die from COVID-19,” he acknowledged.

“We’ve also unfortunately seen deaths in younger age groups … When I looked at the circumstances, unfortunately some of them were not vaccinated – so that certainly would be a known risk factor for severe COVID,” he explained.

Alternatively, those who have succumbed to COVID-19 might have had other medical conditions that made them more vulnerable overall, Oglaza said, so even vaccination might not have had sufficient protective factors.

“Each clinical situation is certainly different … we are analyzing this data very, very closely. This is something we share with the province as part of the broader surveillance in Ontario,” he shared. 

“Any time there is an increased risk of transmission, there’s an increased risk of hospitalizations … it’s unfortunate that we are seeing the severe presentations of COVID. They are relatively rare … Unfortunately, we are bound to see more hospitalizations, and … there might be more deaths,” Oglaza warned.

So what makes this wave of the pandemic different?

“The main thing that changed between what we see now and what we’ve seen in previous waves is that we are dealing with a different variant,” the MOH explained. “This is a highly transmissible variant that’s known to spread in many international jurisdictions, despite all the measures being followed, and sometimes even more stringent [measures than here in Ontario] – despite lockdowns, despite continued masking. So we know that stopping the [spread] of this highly transmissible virus is not something that’s possible.”

“In this province, the key strategy is to reduce the risk to those who might inevitably get exposed and then infected and sick with this virus,” he continued. “So that’s why the emphasis is on immunization, and is now on antiviral medication, [with] masks being that additional, recommended measure.”

Oglaza re-emphasized, “What is going to set [KFL&A] apart from other jurisdictions that are experiencing much more severe impact on a population level is the fact that we’re highly immunized … and also the high vaccine uptake among the most vulnerable.”