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Atlantic Canada's vaunted COVID-Zero strategy no match for Omicron variant

HALIFAX — Through most of the COVID-19 pandemic, Atlantic Canada won international praise for the region's largely successful efforts to keep infection rates low — but the arrival of Omicron has upended its vaunted COVID-Zero strategy.

HALIFAX — Through most of the COVID-19 pandemic, Atlantic Canada won international praise for the region's largely successful efforts to keep infection rates low — but the arrival of Omicron has upended its vaunted COVID-Zero strategy.

The highly contagious variant — now described as the fastest-spreading virus in human history — has overwhelmed the four provinces' get-tough-quick approach, which involved rapidly imposing the country's strictest lockdown measures at the first sign of an outbreak.

It may seem laughable now, but in April of last year, Nova Scotia called in the army and declared a two-week lockdown when the province recorded only 96 new infections — at the time, a one-day record high.

Last Sunday, with Omicron on the move, Nova Scotia reported another record: 1,184 cases in one day.

"In the early stages of the pandemic, the transmissibility (of COVID-19) was a lot less," said Susan Kirkland, head of the department of community health and epidemiology at Dalhousie University in Halifax.

"It was possible to maintain this strategy of COVID-Zero. We did our best to identify every single case with thorough contact tracing ... But we're at a completely different phase of the pandemic now." 

On Wednesday, health officials in New Brunswick confirmed the province would stop including in its news releases the number of daily cases confirmed by PCR testing, because the latest figures no longer reflect the severity of the situation in the province.

Earlier in the day, Prince Edward Island had reported 222 new cases — a record daily high. Before Omicron arrived in Canada in late November, the Island had recorded a total of just 373 positive cases since the beginning of the pandemic.

In Newfoundland and Labrador, where case counts have also spiked, the health-care system is under considerable strain because about 1,000 health-care workers are in isolation or infected with COVID-19. The province's chief medical officer of health, Dr. Janice Fitzgerald, conceded Monday that "most people" will contract the virus and the latest measures are aimed at slowing the spread.

"The transmissibility of Omicron is so great that a COVID-Zero strategy is simply not feasible," said Kirkland, who is also a member of the federal government's COVID-19 immunity task force. "It's not helpful at this point. It's not the right strategy."

Tight lockdowns, which strained the Atlantic economy, simply don't make sense at a time when virus-related hospitalizations in the region remain low, thanks to high vaccination rates that may have lessened Omicron's impact on public health, she said.

But it would be a mistake to assume the COVID-Zero approach was undermined solely by Omicron's lightning-fast spread, says Colin Furness, an infection control epidemiologist at the University of Toronto.

It's important to remember that one of the key pillars of the strategy — the Atlantic Bubble — was largely abandoned across the region in November 2020, Furness said in an interview. The novel policy allowed the region's residents to travel between the four provinces but it imposed a mandatory 14-day quarantine for visitors from outside the region, a move that kept travel-related infections in check.

Each of the Atlantic provinces maintained their own travel restrictions after the bubble burst, but most of those measures have been changed as the pandemic evolved and vaccination rates rose. 

Furness said travel restrictions remain an effective means of controlling the spread of contagious viruses. 

But Kirkland said the Atlantic Bubble was not sustainable.

"We had the Atlantic Bubble, and it was very effective in the first wave of the pandemic, but this is part of learning to live with the pandemic," she said. "We can't isolate ourselves from the world forever ... For us in the Atlantic region, it's been hard for us to adapt because we've been so vigilant."

That sense of vigilance, however, slipped in July 2021 when the region's consistent public messaging on COVID-19 was essentially scuttled by New Brunswick. Premier Blaine Higgs decided his province would be the first in the region to lift all health-protection orders, including mask-wearing requirements.

"New Brunswick broke from the pack," Furness said, adding that vaccination rates in the province also slowed to a crawl. "That really fractured the region."

By late September, the resulting surge in Delta variant infections and hospitalizations prompted Higgs to impose so-called circuit-breaker lockdowns that were extended in October. A senior provincial health official later admitted that the decision to lift all restrictions was a mistake.

"Now, (the Atlantic region) has a real uphill battle," Furness said. "You've squandered all the social capital you have."

During the past 14 days, Atlantic Canada's per capita infection rate has been below the national average, but it was higher than every other province and territory, except Quebec, Ontario and Manitoba, according to federal figures.

This report by The Canadian Press was first published Jan. 6, 2022.

Michael MacDonald, The Canadian Press