With the Premier’s announcement today of a province-wide move to 'emergency brake,' we are certainly not in the place any of us had hoped we would be at this time.

St. Joe's ICU has been at around 100 per cent capacity and we’ve had to implement our surge plan to ensure we can care for the volume of COVID-19 patients expected in the coming weeks. Ontario hospitals are feeling the impact of this third wave.

I know how hard St. Joe's staff, physicians and learners have been working throughout this pandemic, and especially now in this third wave. It has been a long year, and we all just want to spend time with our families and friends. I am so grateful for the work St. Joe's teams do, the compassion you show, and the dedication you give to providing care to our patients, to each other, and to keeping St. Joe’s in full operation.

Where do we find hope through this? I asked Dr. Zain Chagla, infectious disease physician and Medical Director of Infection Control, about this. Zain provided his insight on the third wave, why he’s hopeful for the months ahead, and his advice on how to safely spend time with family during the Easter long weekend.

MELISSA: This third wave reflects the pandemic scenario that we expected last year with hospitals — particularly ICU’s — affected. Why is the third wave different?

ZAIN: The third wave is projected to put significant pressures on hospitals, hitting the ICU’s the hardest. We are seeing an increase in the number of COVID-19 cases, but instead of seeing cases spike in long-term care facilities, we’re actually seeing more severe illness among younger individuals (i.e. those who have not been vaccinated) in hospitals.

It’s also different because variants of concern are now widely circulating in communities, which are considered to be more infectious with higher mortality.

We can expect the third wave to hit the ICU the hardest with more complex, critically ill patients impacted. On any given day in Ontario, 20-30 patients with COVID-19 are admitted to the ICU. This number may increase as the third wave continues, if more intense control measures are not followed.

Here’s the good news: this is likely the last time that we are going to have to deal with COVID-19 from the lens of overwhelming health-care systems, overwhelming ICUs and overwhelming deaths.

MELISSA: How does a province-wide emergency brake help hospitals?

ZAIN: Creating restrictions combined with a steady vaccination campaign is our best path out of the third wave.

While lockdowns have a significant impact on our lives outside of the hospital, they are effective at protecting hospital resources (i.e. helping to ensure ICU beds are available for those who need it) and supporting health-care workers. As challenging as it was, the post-Christmas lockdown was actually very effective in curbing the spread of COVID-19.

This third wave is the scenario we thought we would have a year ago: the healthcare wave. We must control the spread.

MELISSA: Are you hopeful for the months ahead?

ZAIN: After a long haul, this is almost certainly the last hill to climb, but it will be a tough hill. That’s why we need one more province-wide shutdown.

That’s also why St. Joe’s and other healthcare providers are working so hard to help our community be vaccinated. It’s a major line of defense against COVID and path leading to a more normal life for everyone, one where our vulnerable and our healthcare workers are protected, and our hospitals will not experience a similar wave of patients.

MELISSA: What’s your advice for St. Joe's staff, physicians, learners and volunteers in terms of how to navigate this upcoming Easter weekend?

Just like with previous holiday celebrations, indoor, unmasked gatherings can potentially undo all of the progress that we’ve made in controlling the spread of COVID-19. It could also worsen the impact of the pandemic’s third wave.

It is important to avoid indoor meals and sleepovers, but I encourage folks to safely spend time with their household by taking a walk or going to the playground with the kids while physically distanced with others.

MELISSA: What if someone has had one or both doses of the vaccine, does that change what they can do?

ZAIN: We know individuals with two doses of the vaccine have significant protections against symptomatic COVID-19, hospitalization, and death. However, they can still transmit the virus. The Center for Disease Control allows for small gatherings of only fully vaccinated individuals together without masks. Interacting with unvaccinated individuals still poses a transmission risk, even if you are protected.

One dose of vaccine is trickier, as it’s very good but not equivalent to two doses. People are protected, but not perfectly, and the advice is to use it as a layer of protection, along with doing it outdoors while distancing. This adds another layer of protection to yourselves and those around you.

MELISSA: I would normally visit with my parents and my extended family. We are going to have a quieter Easter this year. How about you?

ZAIN: Hopefully a quiet weekend with family and enjoying some outdoor time in the backyard, and taking the barbeque for a spin. I would have loved to see my parents, but learning they are going to be vaccinated soon makes me really hopeful for the future.