Managing COVID: Now It’s Up To Individuals

by Raywat Deonandan

March 1, 2022

This article was first published in The Ottawa Citizen under the title, “Deonandan: Managing COVID — now it’s up to individuals” on March 1st, 2022.

Effective today, Ontario has lifted capacity limits in all public spaces and done away with the controversial so-called “vaccine passport” system, which required that access to certain venues be restricted only to those who could prove that they are at least two weeks out from having received two doses of an approved COVID-19 vaccine.

We can debate the question of whether it is scientifically defensible to do away with the passport system (it probably is) or whether it should be kept but with three doses as the new requirement (it probably should be). What is more pressing for most Ontarians is: Given this new reality, how do we govern our activities and choices for maximum public health benefit and individual safety?

It’s worth remembering that this pandemic has always been mostly about population risk, not individual risk. For most individuals, the probability of a bad outcome from COVID is small, especially in the era of vaccination. It has always been the threat to the population — most acutely to the health care system — that defined the crisis. Having said that, some individuals remain more at risk than others: the immunocompromised, the medically frail and the unvaccinated, especially children under 5 who are not (yet) eligible for vaccination.

So if you are, or your family includes, some of those individuals, your ability to navigate the new world will be compromised: the distribution of risk is not equal. As provincial public health restrictions end, and yet the pandemic rages on, responsibility for managing the pandemic has essentially been downloaded onto the individual. And the desire and ability of each individual to manage risk will vary considerably.

The formula for assessing individual risk is duration multiplied by intensity. The longer you spend in a risky setting — for example, a crowded gym with unmasked and unvaccinated patrons — the higher the probability that you will receive an infectious dose. It helps not to linger too long in such settings.

But how to lessen or reduce intensity?

First, despite misinformation to the contrary, mask-wearing continues to be a relatively low-cost and high-impact activity. Even if everyone around you is infected and infectious, a properly worn n95-style respirator will offer you excellent protection for a period of time, probably hours. You have the power to continue to wear your mask even if it’s no longer legally required.

Second, physical distancing is not as impactful for an aerosolized disease as one might hope; but the more people there are in a venue, the higher likelihood there is that one of them is infectious. Seeking less crowded places is an easy strategy to reduce risk.

Third, Omicron has reduced the ability of two vaccine doses to curtain transmission, but not entirely. And a third dose largely restores that ability. Choose to associate most closely with vaccinated people — preferably triple-dosed — and your risk of exposure falls further.

Fourth, venues with improved ventilation offer less exposure to risk, especially for short-duration visits lasting a couple of hours. Modern cinemas, theatres and halls with state-of-the-art filtration that periodically introduces fresh outside air substantially reduce the chances of exposure.

Outdoor activities, such as athletics, continue to have smaller risk profiles, as do short duration activities with limited human interactions, such as shopping.

The risk of COVID exposure will never be zero again. But no matter what activity you wish to undertake, and no matter what its risk level, individuals can choose to be fully vaccinated, limit the duration of their exposure, and wear a good mask. The government no longer manages this pandemic. We must therefore take action as individuals to calibrate our own risk-taking.

Raywat Deonandan is an Epidemiologist and Associate Professor with the Faculty of Health Sciences, University of Ottawa.