Alberta to adjust COVID-19 masking, isolation, testing rules over next month

Alberta is ending isolation requirements for people who test positive for COVID-19 and their close contacts, even as cases climb in the province. Tom Vernon has more on the multi-phased approach to eliminate the few remaining public health orders in the province.

In several phases, Alberta will be changing some COVID-19 rules around masking and isolating to recommendations, as about three-quarters of eligible people have at least one dose of vaccine.

Starting Thursday, close contacts will no longer be notified of exposure by contact tracers nor will they be legally required to isolate — although it still recommended.

The province will also end asymptomatic testing.

Further measures will be eliminated Aug. 16. People who test positive for the virus will not be mandated to isolate at that time but it is still strongly recommended. Isolation hotels will also close as quarantine supports end.

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Nearly 75.6 per cent of eligible Albertans have now received at least one dose of COVID-19 vaccine, and 64.3 per cent are fully immunized.

The changes are being made, in part, to better manage public health resources, Dr. Deena Hinshaw explained on Wednesday.

“COVID is not over… COVID will not be eliminated. We need to learn to live with it.

“COVID is not the only threat that we’re facing,” Alberta’s chief medical officer of health added.

Daily COVID-19 numbers

On Wednesday, Alberta identified 194 new COVID-19 cases out of about 7,100 tests. Alberta’s positivity sat at about 2.9 per cent.

There were 84 Albertans in hospital with COVID-19, including 18 in ICU.

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As of Wednesday, Alberta had 1,334 active cases.

“Cases have risen recently, almost entirely in those who have not yet been vaccinated, as we expected would happen as people are in close contact with one another,” Hinshaw said.

Since July 1, people who were not immunized made up 95 per cent of confirmed cases, 92 per cent of those requiring hospital care and 95 per cent of COVID-19 deaths, she said.

Still, hospitalizations continue to decline.

“While COVID cases may rise… a surge in hospital admission and severe outcomes is much less likely thanks to vaccines,” Hinshaw said.

“Having two doses of COVID vaccine has never been more important.”

In terms of key metrics, she said case numbers are less important than the rates of hospitalization and severe COVID-19 cases.

In a few steps — July 29, Aug. 16 and Aug. 31 — Alberta will make changes to make sure it’s ready to care for all patients, including those with COVID-19 and other respiratory viruses, like influenza, which Hinshaw said are expected to increase late this summer and into fall.

Testing for severe COVID-19 cases, provincial monitoring, outbreak management in high-risk settings, and other key measures will remain in place. Health officials will be able to adapt as needed if hospitalizations due to COVID-19 spike, the province said.

“Our health system will keep protecting Albertans who are exposed to COVID-19 while also ensuring that we are able to handle all other viruses and illnesses,” Health Minister Tyler Shandro said. “As the majority of us are vaccinated against COVID-19, we are adapting to make sure that the health system is ready to care for all Albertans, whatever their illness.”

Changes effective July 29

– Quarantine for close contacts will shift from mandatory to recommended. Isolation for anyone with COVID-19 symptoms and for confirmed positive cases is still required.
– Unimmunized individuals who know they have been exposed to COVID-19 should monitor for symptoms and seek testing if they become symptomatic.
– Anyone who is not fully immunized should avoid high-risk locations such as continuing care facilities and crowded indoor spaces if they have been in contact with a case in the past 14 days.
– All positive cases will continue to be notified. Contact tracers will no longer notify close contacts of exposure. Individuals are asked to inform their close contacts when informed of their positive result.
– Contact tracers will continue to investigate cases that are in high-risk settings such as acute and continuing care facilities.
– Outbreak management and identification will focus on high-risk locations, including continuing and acute care facilities and high-risk workplaces. Community outbreaks with a surge in cases leading to severe outcomes will also be addressed as needed.
– Asymptomatic testing is no longer recommended. Testing will continue to be available for individuals who are symptomatic.
– Mandatory masking remains in acute and continuing care facilities, publicly accessible transit, taxis and ride-share.

“Over the next two weeks, we will closely monitor these changes and adapt as needed,” Hinshaw said.

Changes effective Aug. 16

– Provincial mandatory masking orders will be lifted. Some masking in acute care or continuing care facilities may still be required.
– Isolation following a positive COVID-19 test result will no longer be required, but strongly recommended.
– Individuals with symptoms of any respiratory infection should still remain at home until symptoms have resolved.
– Staying home when sick remains an important way to care for those around us by not passing on any infection.
– Isolation hotels and quarantine support will no longer be available.
– Testing will be available for Albertans with symptoms when it is needed to help direct patient care decisions.
– This testing will be available through assessment centres until Aug. 31 and, after that, will be in primary care settings including physicians’ offices. For those with severe illness requiring urgent or emergency care, testing will be available in acute care and hospital settings.

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– COVID-19 testing will also be offered as needed in high-risk outbreaks such as in continuing care facilities.
– Public health will focus on investigating severe cases that require hospitalization and any deaths due to COVID-19.
– Outbreak management and preventative measures will continue focusing on outbreaks in high-risk settings, such as continuing and acute care facilities.
– Community outbreaks will continue to be addressed as needed.
– Daycares and schools will be supported with measures that would be effective for any respiratory virus if outbreaks are identified.

Changes effective Aug. 31

– COVID-19 testing will no longer be available through assessment centres. It will be available in primary care settings including doctors’ offices or in acute care and hospital settings.
– Universal masking will not be required in schools once students return. However, it is recommended as a temporary outbreak intervention in response to respiratory outbreaks. A guidance document to support return to schools is being finalized and will be released in mid-August.

“Our top priority is supporting the health of Albertans,” Hinshaw said.

“COVID-19 is still with us but we are now in a place where we need to manage it through vaccinations and the proven public health measures used for other communicable viruses.

“We expect to see increased influenza and other viruses this year, and these changes will make sure the health system is ready and able to support all Albertans in the months ahead.”

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Dr. Craig Jenne, an infectious disease expert at the University of Calgary, said it’s good to see hospitalizations and intensive care unit admissions decline but noted that they are lagging indicators.

“We have the fewest protected people and yet also the fewest public health guidelines to help limit that spread if an outbreak begins,” he said Tuesday, referring to Alberta’s lower vaccination rate compared to other provinces.

“It doesn’t guarantee that we’re going to see a dramatic rise in cases, but it absolutely creates the potential for rapid and sustained viral spread.”

If the numbers were to change, he said, the province would need to consider reintroducing some public health restrictions.

Hinshaw said further action would be considered if Alberta sees a surge in cases in a localized area leading to severe outcomes or if a variant strain arrives that doesn’t respond to the vaccines.

Edmonton mayor Don Iveson said he was surprised the province decided to lift more public health restrictions when Alberta was seeing a rise in cases and variants.

Iveson said the city is monitoring the COVID-19 situation closely and council will discuss any changes to the local response on Aug. 12.

“We need more Edmontonians to get vaccinated so that we can protect ourselves and our communities.

“Unvaccinated people account for the majority of new COVID-19 cases, hospitalizations and deaths in the province,” he said in a statement.

“I am really pleased to see so many Edmontonians choosing to wear masks in grocery stores and other public environments — this helps to protect loved ones who cannot yet get vaccinated, like our children under 12.

“If you feel safer wearing a mask in crowded public areas or wish to maintain some degree of physical distance, please do so. I encourage others to give neighbours the time, space and room to do that free of judgement.”

This was the first time Hinshaw had a news conference since her regular COVID-19 updates stopped one month ago.

On June 29, she urged Albertans to continue to make “safe choices” after restrictions are lifted. Hinshaw also encouraged people to get vaccinated, continue with good hand hygiene and weigh the benefits vs. the rewards of activities.

Most of Alberta’s public health restrictions lifted on July 1.

Since then, bars and restaurants have been welcoming customers back without mandatory capacity limits or masks and events like the Calgary Stampede went ahead.

In mid-July, Alberta’s active case numbers started going up. On July 14, there were 569 active COVID-19 cases in the province; by July 22, there were 676; and on July 27, there were 1,173 active cases.

Alberta’s positivity rate has also been rising. It was 0.68 per cent on July 14, 1.09 per cent on July 22 and 1.99 per cent on July 27.

The R value — or reproductive/transmission rate — has also been going up. It was 0.84 the week of July 14. The latest R value — released July 26 — was 1.48 for Alberta.

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However, hospitalizations and ICU admissions due to COVID-19 have continued to slowly decline.

On June 14, there were 113 Albertans in hospital, including 33 in ICU; on July 22, there were 93 people in hospital with COVID-19, including 26 in ICU; and on July 27, there were 82 people in hospital, including 21 in ICU.

So far, 75.5 percent of Albertans 12 and older have received at least one dose of COVID-19 vaccine and 63.9 per cent are fully vaccinated.

Dr. Jia Hu, a medical officer of health with AHS for the Calgary zone, said Wednesday he’s pleased with Canada’s vaccination rates so far.

“I am feeling pretty good. Things that I would not have expected eight months ago is Canada being the global leader in vaccination uptake, that’s really nice.

“I generally feel good about the summers here. Last summer, when nobody was immunized, we didn’t have too many cases,” he said. “The next time we will be challenged, if we are, will be the fall.”

Hu said the numbers reinforce the need for people to be immunized.

“Across Canada and the U.S., 95-99 per cent of people in hospitals have not been vaccinated. If you’ve been vaccinated, it’s very, very, very unlikely you’ll end up with any bad outcomes.”

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Hu, who also served as Calgary Stampede’s medical director, expected to see an uptake in cases when Alberta reopened July 1.

“The question is what the magnitude will be. Obviously, it’s something we want to keep an eye on, something we can use to encourage people to get vaccinated for.

“But you know, I think if the cases tend to be in younger people, the infection is milder, hopefully they’ve had at least one dose of vaccine, the number of severe cases hopefully won’t go up too much,” Hu said.

“We’re never going to get rid of COVID; we’re going to live with it and try to balance a certain amount of reopening with a certain amount of COVID cases.

“If we see an increase in cases — which no doubt we do — but we don’t see as much in terms of severe COVID, I think that’s going to be OK.”

Dr. Daniel Gregson, a physician, infectious disease expert and associate professor at the Cumming School of Medicine, agrees opening up means more transmission.

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“We’re having a bit of a bump right now, and if the numbers continue to increase, it’ll migrate into a full wave, similar to what they’re seeing in the U.K… Hopefully that will not translate into as many admissions and deaths that we’ve seen in previous waves.

“The only thing we have going for us now is that really this transmission is occurring primarily in a younger population than our previous waves,” he said.

But it remains to be seen if the increasing case numbers will lead to increases in hospitalizations, Gregson said.

“The question we have really is: how much activity can we tolerate? And how much burden can we put on the health system?”

He believes Canada’s experience could be somewhere in the middle of what the U.K. and Israel have seen, “with some increase in our hospitalizations, if not through the summer than in the fall. I guess the important thing is it’s going to be in people who are not immunized and that’s a fixable problem.”

— With a file from The Canadian Press

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