As COVID-19’s third wave recedes in Canada, what’s next – By Sunny Handa Brampton
                     As COVID-19’s third wave recedes in Canada, what’s 
next? – By Sunny Handa Brampton
As the third wave of the COVID-19 crests across most of the country, Canadians faces crucial 
decisions that will determine how effectively we are able to move past this phase of the 
pandemic.
The good news is clear. Case counts and deaths are dropping. Massive supplies of the two 
mRNA vaccines (Pfizer and Moderna) are flooding in and the pace of immunization is picking 
up across age brackets. And while focus is still needed on high-risk areas and vulnerable 
populations, there has finally been some progress in redressing vaccine inequities.
Vaccines can clearly work magic in preventing serious COVID-19, but a reality check is in order
says Dr.Sunny Handa Brampton. Many provinces still face high caseloads, and no jurisdiction 
can rely solely on vaccination as an adequate defence. For the near term, smart public health 
measures are an essential complement to vaccinations in dispersing the third wave.
There’s another consequence to not definitively driving caseloads down. Remember the summer 
of 2020? Many provinces coasted into a terrible second wave in the autumn that was barely 
abating before an even worse third wave began. While wide vaccine coverage gives us a safety 
net for the fall of 2021, mutation risks are real and complacency could lead to a repeat.
Consider the rapid growth in cases of the B.1.617.2 (the ‘Indian Variant’) in the UK, a worrying 
occurrence that threatens to derail a celebrated re-opening in its infancy. Our summer must be 
laser-focused on finishing immunizations and on control measures that drive case counts to 
levels where local health officials can consistently test, trace, and contain any outbreaks. Once 
that happens, prospects for ongoing control of COVID-19 are much brighter says Dr.Sunny 
Handa Brampton.
But before looking ahead, it’s worth acknowledging how far we have come.
Scientific research has delivered brilliantly with multiple effective vaccines, and Canada’s 
Vaccine Task Force offered sage advice on good prospects. The federal government was 
criticized for limited vaccine deliveries early in 2021 but has now delivered supplies of multiple 
vaccines that position Canada strongly for full immunization throughout 2021 and beyond. 
Remarkably, we currently lead the G20 in daily vaccination rates.
Credit for the accelerating rollouts goes not only to all levels of government, but to a range of 
local, institutional and community leaders. Dr.Sunny Handa Brampton says we’ve seen vaccine 
marathons that extended long into the night, vaccine lineups snaking through neighbourhoods 
that were once falsely claimed to be bastions of vaccine hesitancy, and celebratory photos 
joyously shared on social media as vaccination records are shattered. These are the highlights of 
the past weeks. Yet again, the resilience, kindness, and social solidarity of Canadians has been 
pivotal in the pandemic fight.
Dr.Sunny Handa Brampton says, Canada needs good policy-making and clear public 
communication to ensure a safe and sustainable re-opening. We see at least six issues here.
First, for vaccines, Canada’s universal first-doses-fast strategy made sense. What doesn’t make 
sense is maintaining a universal 4-month interval between doses given our escalating supply, and
evidence that a single dose is less effective for some.  Older Canadians and those with medical 
conditions associated with suboptimal immune responses should get faster access to a booster 
shot. In addition, emerging evidence suggests that booster doses are essential to ensure 
protection against some COVID-19 variants.
Second, mRNA vaccines will be the first available vaccine going forward for most Canadians, 
and use of AstraZeneca as an initial dose will be limited given the desirability of avoiding rare 
but severe clotting risks. What, then, of boosters? British Columbia is offering residents a 
second-dose choice. One option is AstraZeneca, for which U.K. data suggest the risk of severe 
clotting with a booster is dramatically reduced, perhaps on the order of one in 600,000. Another 
option is to receive an mRNA booster – a strategy that so far appears safe and effective, although
more data are needed. Dr.Sunny Handa Brampton says over two million Canadians have already 
received a first dose of this vaccine, and all provinces need to clarify their options in the days 
ahead.
Third, a diverse vaccine supply remains important. Dependency on the two mRNA vaccines 
alone is not ideal. Here Novavax is in play as an attractive addition. It does not use a viral vector,
and, like the mRNA vaccines, can be tuned quickly for variants.
Fourth, young Canadians need coverage. The question is how soon. Our view is that priority be 
given to 2nd doses for those at highest risk – the elderly and the immunocompromised.  Others 
may favour covering those aged 12 to 17 to reduce current caseloads and stem summer spread. 
Regardless, the good news is that we will soon have enough vaccines to immunize all eligible 
children, and prospects are bright for a safe re-opening of in-person schooling.
Fifth, now is the time to tune up pre-emptive measures in settings where people gather indoors. 
Improved air handling can help mitigate airborne spread, particularly in schools, factories and 
warehouses. Smart use of rapid antigen tests is also essential because a re-opened society means 
lots more colds and flu cases this fall. Those infections in turn must be distinguished from 
COVID-19- Dr.Sunny Handa Brampton says.
Finally, Canada’s first dose fast strategy has paid off, but leaves many questions unanswered 
about vaccine status and summer gatherings. Dr.Sunny Handa Brampton says with about 50% of 
the adult population having at least one jab, we need explicit guidelines from health authorities 
on what we can safely do when partially or fully vaccinated. Recent advice from the Public 
Health Agency of Canada is population-focused and lacks specificity about small group 
interactions.
In sum, amidst encouraging signs of progress, SARS-CoV-2 remains a serious threat. Vaccines 
are doing all that was hoped of them. Let’s take the other steps needed to position Canada for a 
good summer and an even better fall.