Save lives. Restore mask requirements in Saskatchewan's medical settings now.

Why is COVID-19 transmission something we should prevent?

Here are some facts about why COVID infection and reinfection is bad, and why preventing infection and reinfection of COVID-19 should be a matter of urgency for the Saskatchewan provincial government.

What most people thought to be true about SARS-CoV-2 in 2020, 2021 and 2022 needs to be updated and accurately communicated by governments, media, and public health authorities.

COVID’s harm comes not only from the infection phase, but from long-term effects after infection:

The main harm most people associate with COVID-19 is thought to be in the the “acute phase” of COVID infection. People are typically infectious for roughly 10 days with symptoms that resemble colds or flus. For this reason, COVID-19 is thought to be mainly harmful to medically vulnerable and elderly people, who it hospitalizes and kills in greater numbers than younger people. Many people who survive COVID-19 thus mistakenly compare COVID-19 infection to a cold or a flu.

Even if this were the only harm that COVID caused, we should implement safety measures to prevent widespread COVID infection and re-infection. While the dominant “Omicron” lineage and variants are considered to be less “virulent” they are also more infectious. As a result, COVID-19 killed more people in Canada (and Saskatchewan) in 2022 than in 2021.

Many people wave away such concerns as “COVID is only killing old people” or “only people with underlying conditions are dying.” While this is ageism in the extreme because elderly people are human beings, COVID in fact kills younger adults in significant numbers. Similarly, even as devaluing people with pre-existing conditions and accepting their deaths as inevitable is ableism, it is also a misconception that “healthy people” are immune to dying from COVID-19. We should not organize healthcare (or public health) around ageism or ableism.

The harms from COVID-19 after infection

However, emerging research, which has been around from close to the beginning of the pandemic, shows that COVID is harmful in two other ways:

1 – Long COVID, or “Post COVID-19 condition.”

Post-COVID-19 infection is “when the symptoms of COVID-19 persist for more than 12 weeks after the infection.” Long COVID can occur “even in those who have mild or asymptomatic infections and in young and healthy individuals.”

Current estimates of people in Canada who have suffered from Long COVID vary, but all estimations indicate that Long COVID is not uncommon. Statistics Canada found that nearly 15 per cent of people “have experienced lingering symptoms such as fatigue, shortness of breath, and brain fog three months after their initial infection.” A large majority of people with Long COVID symptoms miss work or school by an average of 20 days, and a shocking 47% of people have symptoms for a year or longer.

Also, some studies have shown that Long COVID is keeping significant numbers of people out of work for months or indefinitely. An analysis of workers’ compensation claims in New York found that 71 percent of claimants with long Covid needed continuing medical treatment or were unable to work for six months or more.

Long COVID is thus indefinitely debilitating some working-age people, and it has been called a potential “mass disabling event” with serious implications for Canada’s economy.

2 – Organ damage that COVID-19 inflicts on the body.

Previously thought to be merely a respiratory disease, events like brain fog, heart issues, fatigue, and even heart attacks and strokes that can be fatal. It is believed that Long COVID emerges from this damage to a large variety of organs which afflicts the majority of people who contract COVID.

However, anyone contracting COVID can experience some kind of organ damage from the disease whether symptoms are present or not. This includes young people. These include:

  • the cardiovascular system,
  • the nervous system,
  • the muscoloskeletal system,
  • endocrine and gastrointestinal system,
  • and the brain.

See this diagram here.

For this reason, we believe that COVID-19 infection should absolutely not be lumped in with other respiratory infections — as the Saskatchewan government now explicitly does — just because breathing is a mode of COVID-19 transmission.

From Take Action for COVID’s perspective, governments in Canada have done a poor job of communicating the harms of Long COVID and warning the public. Since no treatments exist, the best way to stop Long COVID is to stop transmission of COVID, and stopping transmission should be a priority of public health and government.

In particular, the Saskatchewan government, as of this latest update (04/25/2023) makes no mention of Long COVID. These misconceptions are reflected when asking about Long COVID when calling 811. As of this writing, the Saskatchewan Health Authority website has a section about Long COVID, but it is not backed by any campaign — advertising or otherwise.

COVID is airborne

Finally, SARS-CoV-2 is still often thought to be a disease spread mainly by droplets, or treated like such. However, owing to conflicting definitions of “airborne” and the historical prevalance of defining respiratory diseases as spread by droplets, the World Health Organization (WHO) did not recognize COVID-19 as airborne until at least a year into the pandemic, and “early in the pandemic, the World Health Organization stated that SARS-CoV-2 was not transmitted through the air.”

If COVID is airborne, this implies that it’s a greater danger. Rather than droplets that quickly fall to the ground, COVID-19 spreads through the air like smoke. You do not need to be in especially close proximity to an infected person to get infected. “Transmission of COVID-19 from inhalation of virus in the air can occur at distances greater than six feet. Particles from an infected person can move throughout an entire room or indoor space. The particles can also linger in the air after a person has left the room – they can remain airborne for hours in some cases.”

What are the implications of COVID-19 being an airborne disease that causes long-term harm to organ systems?

And what about the risk that goes up with each re-infection?

While most briefings about Long COVID mention that the primary series of vaccines as reducing the incidence of Long COVID, and this is wonderful news, this by no means eliminates the problem of Long COVID.

Long COVID introduces serious health conditions in a large percentage of individuals who contract it. Not only does this create a lot of misery for individuals and families, we are likely building up a massive population health problem down the road— a “mass disabling event.” Uncontrolled COVID transmission is certain to do harm to the economy as well.

Therefore, the Saskatchewan government should resume pro-actively dealing with COVID, rather than minimizing its harms.

It should be provincial public health policy to reduce COVID transmission in settings where it is likely to transmit.

Airborne transmission means that rather than reducing public health mitigations and requirements, we need more and better mitigations. In particular, airborne transmission means that we need to do two things: upgrade masks (such as the “baggy blue” surgical masks in hospital settings) to respirators such as N95s and P100s, and clean the air (such as through building ventilation, air purifiers, air quality monitors, and devices like Corsi-Rosenthal boxes).