Unvaccinated putting vulnerable at risk, says Ontario’s chief medical officer of health

McMaster Children's Hospital endorsed a call for in-person learning for this school year, including extracurricular activities.

In a brief published Monday, the Ontario COVID-19 Science Advisory Table also recommended against masks, cohorting and physical distancing when virus rates and risk of severe illness are low.

However, Ontario's chief medical officer of health warned Tuesday the advice may be difficult to implement unless more get vaccinated immediately.

Dr. Kieran Moore said the province has not achieved herd immunity so the unvaccinated are putting the vulnerable at risk.

If we remain at around 20 per cent of the population unvaccinated, we won't build community immunity and you will get breakthrough infections in those individuals who are vaccinated," Moore said particularly about the elderly and the immune suppressed who don't get as much protection from the shot.

That is the concern that unvaccinated still pose a risk."

Vaccination - particularly first shots - are slowing, with younger people having the worst rates. It's a major concern because Ontario is racing to get as many fully protected by September when Delta is expected to surge again.

It takes six weeks from the first COVID shot to get full protection and there are only seven weeks before school starts.

Time is of the essence," Moore said. If you get immunized now, you'll be protected for when we anticipate a rise in cases in September."

How big is the risk?

Over four million people in Ontario are unvaccinated. Of those, 1.5 million can't get the shot because they're under age 12.

That leaves around 2.5 million Ontarians who are eligible to get the vaccine but have not done so yet," said Moore. This is despite having great capacity across Ontario and a steady supply of all mRNA vaccines."

Ontario needs 90 per cent of those eligible to get fully vaccinated to achieve herd immunity against Delta.

As of Tuesday, 79 per cent had a first dose - Hamilton is lagging at just over 75 per cent.

Those numbers have barely moved in a week - Ontario was at 78 per cent on July 13 and Hamilton was at 74 per cent.

It means more than one in five have not received a single dose at a time when we are seeing our vaccination rates slowing and risk of Delta increasing across the globe," said Moore.

It's even worse among the young with about one in three unvaccinated for ages 12 to 34.

Second doses are moving at a faster rate. Ontario was up to 62 per cent Tuesday compared to 55 per cent the week before. Again, Hamilton lags at 59 per cent Tuesday from 52 per cent.

Young people remain behind the pack with just 37 per cent of those age 12 to 17 in Hamilton having a second shot. For ages 18 to 34, it ranges from 44 per cent to 49 per cent.

Why does it matter?

Delta is expected to surge again in September.

We'll be in closed spaces with closer faces in crowded spaces, so our risk will be going up very shortly," said Moore.

The spread is expected to be fuelled by the unvaccinated. June data from Public Health Ontario shows the risk of COVID for those with no shot was 4.7 times higher than the fully vaccinated and 3.4 times higher than those with one dose. Hospitalization was three times higher.

It's disconcerting to me to see the impact that the Delta variant has had in the southern United States and the unvaccinated populations in the U.K.," said Moore. Any potential surge of cases in Ontario will most likely be in those who are unvaccinated or partially vaccinated. We have time to avoid that reality."

What is at stake?

COVID numbers continue to trend in the right direction but there have been some concerning upticks in Hamilton.

An outbreak at St. Joseph's Villa increased by two cases Tuesday to bring the total number infected to 14. The Toronto Star has linked the outbreak to an unvaccinated hairdresser at an on-site salon.

In addition, Hamilton has three other outbreaks, including 15 cases at Arbour Creek Long-Term Care Centre.

Hospitalizations increased by more than 50 per cent in 24 hours to 29 on Tuesday, including 13 in the intensive care unit.

Either get immunized or we have to continue to fight outbreaks in our community," said Moore.

He had particularly strong words for unvaccinated health-care workers: It's the responsibility and obligation of any health professional to be immunized if you are taking care of patients."

What about reopening?

The Children's Health Coalition - which includes McMaster Children's - is strongly urging the government to accept the science table's back-to-school recommendations.

Many kids continue to be in crisis as a result of prolonged periods of social isolation and interruption to regular routines," hospital president Bruce Squires said in a statement. In-person learning and school-based extracurricular activities are absolutely critical for students' health, well-being and development."

Hamilton's weekly rate per 100,000 population was 12 as of July 18, which is above the threshold of less than 10" set by Moore on Tuesday to avoid masks, cohorting and social distancing.

Of the recommendations, Moore said, That may be difficult to implement and it may be that we have a very cautious start in September and then monitor the situation because I don't know if we'll achieve that high community immunity that we need in September."

Higher vaccination rates aren't just for schools, Moore said, it's also needed to allow our society to return to a more normal state."

Joanna Frketich is a Hamilton-based reporter covering health for The Spectator. Reach her via email: jfrketich@thespec.com