British Columbia’s recent decision to manage the highly transmissible Omicron variant more like the common cold is raising concerns about consistency and transparency from public health and communications experts.
And while the province was clear COVID-19 is not yet endemic — that is, naturally maintained at a level that does not overwhelm the health system — in B.C., experts say the changes have left the public with the impression they’ve given up trying to protect people from COVID-19 infection.
On Friday, provincial health officer Dr. Bonnie Henry removed minimum isolation requirements for people who are double-vaccinated and come in close contact with a positive COVID-19 case.
As long as one feels well, she said, close contacts can go about their lives as normal as long as they avoid high-risk settings like long-term care. “We cannot eliminate all risk,” Henry said.
The province has also eased restrictions so that patients who are COVID-positive can share hospital rooms with non-COVID patients.
Experts say the changes, confirmed on Friday after first being posted to the BC Centre for Disease Control and Fraser Health websites, are inconsistent with the fact that almost 1,000 COVID-19 patients are in hospital and there are many more health-care workers who are sick, experts say.
And they are inconsistent with the province’s warning that vigilance is still needed, particularly for high-risk and immunocompromised people, and that Omicron should not be considered a mild illness.
Heidi Tworek, who holds the Canada Research Chair in history and policy of health communications at the University of British Columbia, said the messages risk confusing the public.
“We got acknowledgement that Omicron isn’t as mild, because it’s causing extreme stress in the health system, but then they are removing isolation requirements,” Tworek said. “It’s a bit of a mixed bag and getting close to self-contradictory.”
Alice Fleerackers, a PhD student in health communications at Simon Fraser University, said that after almost two years of changing orders and rules, the latest inconsistencies are sowing doubt about why these decisions are being made and whether people should trust them.
“Consistency is another cornerstone of risk communication,” said Fleerackers, “This doesn’t feel very consistent.”
The new guidance was also posted online before being announced, a misstep Henry apologized for and said was due to COVID-19 illnesses and stress among public health staff.
Double-vaccinated people who develop symptoms or test positive must still isolate for five days and avoid group settings for five days after the isolation period.
Henry cited Omicron’s shorter incubation period in reducing the isolation period to five days. But some studies have shown Omicron reaches peak infectiousness three to six days after a positive test or symptoms begin.
And many double-vaccinated people without symptoms can become infected and transmit the virus to others.
Omicron is more easily transmitted than the Delta variant. An infected person has a 31-per-cent chance of transmitting the virus to a member of their household within a week, compared with 21 per cent of cases for people infected by the Delta variant. Those with a booster have significantly more protection than those with just one or two doses against Omicron.
Dr. Lyne Filiatrault, a former emergency physician and member of advocacy group Protect Our Province BC, said the new isolation rules don’t reflect current research.
“People in the same household are at higher risk of getting infected and it doesn’t stop shedding after five days,” she said. “They’re basically abandoning people in terms of protecting us from getting infected.”
Tworek agreed that most of the communication on Friday appeared “geared towards people who wanted everything to be open again.”
There was little direction for how people who are immunocompromised or high risk, or those they interact and live with, should navigate this new phase, she said.
Some disabled people and advocates have said B.C. is expecting them to stay home “so that everybody else can get on with life."
On Tuesday, Henry appeared to address these concerns by saying people need to consider the impact of their actions on others.
“We also need to take collective actions to reduce risk every day,” said Henry, noting that people should not only consider their own risk but the risks of those more vulnerable around them.
Tworek and Fleerackers said Henry should have explained why she believes this is a more effective strategy than measures like continued 10-day isolation.
“Policy decisions are framed as inevitabilities,” Tworek said, noting Henry said things like “we cannot eliminate all risk.”
“Risk communication is not an all-or-nothing thing,” she said. “Different people have different risk tolerances, so it means explaining and contextualizing risks for people to understand.”
And by removing minimum isolation requirements for COVID-19 now as if it were the common cold, Tworek says Henry is further confusing people about what endemic means now, or how she will determine if B.C. has reached it in the future.
“The common cold doesn’t bring an entire province’s health care to its knees,” Tworek said.
Filiatrault and Tworek said people need to know why this decision is being made.
“They’re repeating the same mistake that they did last summer,” said Filiatrault. “They seem to have thrown in the towel.”
Fleerackers added that many questions remain unanswered, like what the plan is to manage future variants, how people should navigate interactions with immunocompromised people, and how the new isolation changes will impact transmission.
“I’m not the only one waiting for these glaring questions to be answered in the coming days or weeks,” she said.