With most Ontario residents experiencing "pandemic fatigue," the Ontario Medical Association (OMA) has offered several opinions and insights on how people might cope with changes in our lives when the COVID-19 pandemic comes to an end.
For some it could be party time. For others it will be a time of difficulty and mistrust.
"It has been 14 months since the World Health Organization declared a pandemic; 14 very long months for everyone. And now people all over the globe are asking themselves how will it end? Because we know pandemics always end," said OMA president Dr. Samantha Hill, during a one-hour online media briefing held Wednesday.
Hill wondered if we would be going back to the lives we lived before, or have things changed to the point that some of our behaviours have changed forever. She said there are many such questions being asked.
"As pandemic fatigue hits all new highs and peaks, but we do see that light at the end of the tunnel," she said.
Hill hosted a panel of medical experts to comment on what Ontario residents can expect in terms of physical health and mental health among themselves and family members. Among the speakers was Dr. Zain Chagla, an associate professor at McMaster University and a medical practitioner who has contributed to local, provincial, and federal policy planning. He was asked to comment on how the pandemic might end.
Chagla predicted "that COVD-19 is going to be around for the foreseeable future and probably the long-term future."
Chagla said despite the vaccines, it will not be enough to eliminate every case. He said COVID-19 will eventually become treatable as an "outpatient" disease.
He added that the question of when will it be over, should be rephrased as when will it be over for the world.
He said the coronavirus is now being spread in South America, Southeast Asia and sub-Saharan Africa with far more contagious variants.
"As we think about our exit plan we need to think about the global exit plan as a part of this," said Chagla.
Chagla added that in Canada we need to set "reasonable benchmarks" on how much health care should be devoted to stopping COVID-19 in the long-term and what we would consider as a measure of success in the long-term. Chagla said it was a vague answer but the pandemic will be over when it no longer threatens other vulnerable populations.
Dr. Allison McGeer, a professor in Laboratory Medicine and Pathobiology at the Dalla Lana School of Public Health at the University of Toronto, also took part in the discussion. She was called on to comment on her role as an infectious diseases specialist.
Hill asked McGeer if she believed the disease would be eradicated completely or if COVID-19 will evolve into something else.
"From a viral point of view, there are still a substantial number of uncertainties," said McGeer. She said one good way to perceive it is that the virus has changed to adapt to humans.
"This might be the end of the story," said McGeer adding that what science is seeing to support that is "a convergent evolution" of different variants.
"So maybe it's going to stop," she added.
McGeer said what is required is for the virus to be stopped by the vaccine for a long period, long enough that there is no infection of other mammals such as dogs or mice or some other species.
She said it is a situation that is still unknown by science.
McGeer said another concern is that the virus might continue to evolve into something like a seasonal influenza that changes over time. If that becomes the case, McGeer said COVID-19 would no longer be regarded as seriously as it is now, but neither would it be "a trivial disease.” She said vaccination against COVID-19 would become a regular thing for most families.
Hill's questions were also directed to Dr. Thomas Ungar, the Psychiatrist-in-Chief at St. Michael’s Hospital of the Unity Health Toronto and Associate Professor at University of Toronto.
Will we be returning to life as we once knew it, or will things be changed permanently, Hill asked Ungar.
"I think what we're going to see, I think it is absolutely normal and expected that people are worried, anxious, depressed and concerned. This is a real and essential threat to health to our society. So, we are hearing the terms of all the people who are anxious and depressed. That is somewhat normal."
Ungar said what is concerning is that many people are emotionally distressed and that will need to be sorted out.
He said it will be up to the infectious disease professionals to determine exactly when the pandemic is over, and that will inspire a small portion of the population to "go wild" with partying, acting like nothing ever happened.
Another part of society, roughly 30 to 50 per cent, said Ungar, would gradually and cautiously slide back into a sense of normalcy and will be accepting of some changes.
Ungar said maybe 10 to 20 per cent will have difficulty moving forward. He said they would remain overly fearful and would avoid others.
He said that part of society would need support and encouragement.
Ungar also mentioned the idea of a fourth wave of the pandemic, or perhaps a fifth wave, being the one that identifies the concerns of mental health.
"We are starting to see that in emergency rooms and acute care centres," he said. Ungar said this has been noticed since the Fall of 2020.
Ungar said there are serious mental health issues that affect people's moods, cause sleep disturbance, lack of interest, lack of energy, concentration problems, feelings of guilt and worthlessness and levels of anxiety to the point where people cannot function.
There is a coming mental health wave that needs to be addressed. He said this in part will be related to the economic impact that comes when government financial support systems stop and many people will be experiencing economic misery.
This would require an enhanced system of support for a lot of people.
"I just hope that people do seek out care and I hope that we are able to provide that care," said Ungar.
Len Gillis is a Local Journalism Initiative reporter at Sudbury.com. He covers health care in Northern Ontario.
