Reduced contact tracing, child vaccination debate revealed to B.C. doctors as province pushes return to normal

Public health officials have told British Columbia's family doctors and other health-care providers that contact tracing has quietly been scaled back; there’s a plan to lift the recently reintroduced mask mandate; and they may not recommend child vaccinations against COVID-19, even if vaccines are approved for such use by federal regulators.

The information came during a continuing education webinar on Tuesday evening, where general practitioners, midwives and other health-care professionals peppered a panel of public health experts and officials with questions about the pandemic.

A public health nurse addressed a question about redirecting nurses involved in contact tracing to other, more urgent sectors, like hospitals, and responded that tracing was only continuing in a rudimentary manner and that vaccinated contacts of those who test positive don’t have to isolate.

“We’re not isolating all of our contacts anymore; there’s very few people that are being isolated now,” said Nomi Mate, adding that officials are most focussed on high-risk people.

“When we’re doing the initial call, it’s really to help somewhat determine how they got COVID, if they got symptoms, what prompted them to go for testing and then going through their infectious period and isolation with them.”

The guidance was quietly changed on the B.C. Centre for Disease Control’s website as well, but the province’s top doctor only discussed reduced contact tracing in Interior Health due to staffing shortages.

One of the senior leaders in Vancouver Coastal Health said there’s also less testing available, but that there’s less demand for it despite rising case counts.

“We don’t have as many service hours available, but we’re still in a phase right now where we are trying to make testing available essentially to facilitate the restart,” said Dr. Mark Lysyshyn, deputy chief medical health officer for Vancouver Coastal Health.

“When we decide we’ve reached enough of a population protection with vaccination and we’ve managed to get society open, then we’ll look at different testing strategies — hopefully shifting to testing just the severe cases and in high-risk settings and then we won’t be as worried about transmission in the population, but we’re not quite there yet.” 

KIDS WITH "A BIT OF A SNIFFLE" ENCOURAGED TO GO TO SCHOOL

The online webinar for health professionals was titled, “COVID-19 Update: Expert Q&A with Public Health, Vaccine, Epidemiology and Lab Specialists,” and provided by UBC’s continuing development program in the Faculty of Medicine.

B.C.’s deputy provincial health officer encouraged the attendees – predominantly family doctors – to send kids back to school if they still had mild cold- or flu-like symptoms but have tested negative for COVID-19.

“They can go back to school as soon as they feel better,” said Dr. Reka Gustafson. “That’s one of the reasons we wanted to make sure testing is available, because the test does allow you to say the child is negative and I can return to school and the family physician can really support that parent in returning to school.”

Another panelist agreed that students with "a bit of a sniffle” can go back to school without being “shoved in the corner of the class.”

That attitude stands in contrast to public health messaging, however. Since the start of the pandemic, B.C.’s provincial and regional health officials have reiterated the mantra of “stay home if you’re sick,” but they’ve also downplayed the seriousness of COVID-19 infections in children, as well as children’s ability to transmit the virus to others. They’ve said this despite experts, family physicians and researchers warning that it could be risky, especially with the Delta variant. 

B.C. EXPERTS MULLING WHETHER TO RECOMMEND CHILD VACCINATION

One of the experts on the panel was Manish Sadarangani, an infectious disease specialist and researcher at B.C. Children’s Hospital, who raised the possibility that the province may not recommend children under 12 be vaccinated against COVID-19, even if Health Canada approves vaccines for children

“We’re trying to prevent severe disease, hospitalization, ICU admission, death — we’re not necessarily trying to prevent every child from getting a cold,” he said, alluding to the assertion COVID generally causes mild illness in children.

"We’ll have a better idea in the coming weeks as to how things are going in schools and I think overall last year things went very well in schools, all things considered.”

Gustafson agreed, noting that much of the world still hasn’t been vaccinated and at-risk people should have access to vaccination before those at lower risk, like children, are prioritized for vaccines that are still in short supply globally.

She also revealed the province is working intently to change risk perception in the public in the weeks going forward.

“I would say we’re in a transition phase where our perception of our risk of COVID is likely causing as much disruption to society as COVID itself,” said Gustafson, pointing out the pandemic is continuing primarily among those who aren’t immunized.

“Every British Columbian over 12 has had a chance to receive two doses of COVID vaccine, so to some extent the return to normal life will depend on how well we can provide calm and confident leadership, how we can actually clearly communicate what are the things that carry a risk and what don’t.”

She described structured settings like schools and most workplaces as having little risk for those fully vaccinated.

"Actually returning to normal societal functioning is a priority,” insisted Gustafson. “It’s a health priority, it’s a society priority and it’s an economic priority.”

Her comments come as infectious disease experts warn vaccination alone is not enough to counteract the highly contagious Delta variant, which has strained entire health authorities and has some B.C. hospitals on the brink of being overwhelmed by unvaccinated COVID-19 patients.

It’s important to note that with a significant percentage of the province still unvaccinated, those critically ill COVID-19 patients are taking up hospital resources, leading to surgical cancellations and contributing to long wait times for help as dramatically understaffed hospitals prioritize the sickest patients.