In conversation with… 

Dr. Robyn Harrison

Fall and winter are typically respiratory illness season in Canada, and with that comes the usual suspects of influenza, RSV, and so many common colds. But, what if anything about the last 18 months has been typical? 

Prairie Manufacturer’s editor, Jeff Baker, spoke with Dr. Robyn Harrison to explore what we’ve learned so far in the COVID-19 pandemic and what we can do going forward to mitigate the impact of the novel coronavirus and other viral infections we typically experience at this time of year.

Dr. Harrison is an Infectious Disease Specialist working in Edmonton and a Clinical Professor at the University of Alberta. She is also Communicable Disease Consultant for the province-wide Alberta Health Services Workplace Health and Safety Program, and Vice-chair of Canada’s National Advisory Committee on Immunization (NACI).

*This conversation took place on August 6, 2021.

Jeff Baker: I must confess, Dr. Harrison, every time I have a conversation about COVID-19 and the impact on business, I hope it’s the last one. However, we’re 18-plus months into this pandemic, and there doesn’t seem to be an ‘end’ in sight. Where are we really at in the terms of the pandemic life cycle?

Dr. Robyn Harrison: While no one knows with absolute certainty what the length of this pandemic life cycle will be, we can be very optimistic that vaccines will shorten it. 

We also know that historically pandemics eventually do end, although they often take two to three years to resolve when there are not effective vaccines or treatments for the circulating virus.

After 18 months’ experience in Canada, and a little longer globally, we see that illness from this virus comes in waves. Unfortunately the virus has not gone away (yet). In fact, we seem to be on the verge of a fourth wave as we speak. 

Fortunately though, for the first time in Canada, we’re in a new and significantly improved era: that of COVID-19 vaccination. This places us in a much better position this fall as compared to last fall.

 We know we have new variants of the virus that have emerged through the pandemic, and that some of those variants spread faster and more easily from one person to others, but we also see an increasing number of people who are gaining protection (including protection from the current variants of the virus) through vaccination. Some have likened this to race between variants of the virus and protection from vaccines. The vaccines are doing very well.

I do not think anyone can predict exactly how the next few months will play out as we look forward to a pandemic finish line. It seems we are getting very close, but we are not quite there yet. The world still needs more people immunized. 

JB: So, are we high fiving too soon?

RH: Well, we’ve got a lot to be proud of at this stage in the pandemic so I think we can high-five a little along the way! I’ve been watching Olympic events this week. The teams can certainly high five the successes that bring them to the Olympic event, and even to those final moments in a race, but we also know things can change in a fraction of a second, so no one can afford to lose focus too early.

Reflecting upon our collective ability over the past 18 months to pivot and adapt to working and living differently when it is necessary to do so is important. Combining that knowledge and practice with the power of vaccines means that we are a lot further ahead this year than we were last year and we should certainly high five that.

We should high-five things like the science that has brought us remarkably effective vaccines. We should recognize the commitment to health that those around us have shown by choosing to be vaccinated and by staying home when ill in order to protect others.

So while we can’t yet declare the pandemic over, we can say that we’re rounding a bend, and we now need to work out how we’re going to get across our finish line safely. It is in sight.

JB: What should we have learned by this point about respiratory illnesses and the impact they have on our lives and society at large?

RH: The SARS-CoV-2 virus (that is the virus that causes COVID-19) has really highlighted our connectivity – our people, our workers, their families, our friends and families, and our travellers. We’re all connected, often in ways that we might not appreciate until we see the spread of a virus. Infections can be acquired during travel, or at a celebration; in the community, in a household, or at work.

Viruses can impact our productivity, cause fatigue or lasting symptoms, or they can lead to loss of life. We cannot always predict who will be most severely affected, and viruses can impact us indirectly when we grieve for others.

I think the SARS-CoV-2 virus has taught us about how we interact with others too, especially where this virus is most contagious in the hours and days when a person first develops symptoms. The virus can spread easily even before people suspect or realize there’s a problem. This has been a major challenge.

What we keep learning with respiratory infections (about ways we can reduce the risk of spreading them) is that outdoors is better than indoors; that we need to stay at home when we’re sick; and that hand washing and physical distancing work to prevent spread. We need to properly consider the “three C’s”: crowded spaces, confined spaces, and close person-to-person contact. If we can manage those, then we can manage the spread of illnesses. 

In addition, effective vaccines are our most powerful tool to add to this prevention mix. Vaccines can help us to stay connected and protected. Some people get vaccines to protect themselves since it offers direct protection to them; and if we all do that, then we can collectively protect many others because if we don’t get sick, then we’re far less likely to pass something on to someone else. 

JB: The public health and hygiene measures we’ve been practicing over the last 18 months – isolation, physical distancing, barriers, masking, etc – are old hat for most of us, but some rules are changing in some places. What should we consider continuing to do through the coming respiratory illness season?

RH: We’re entering a whole new phase now, facing a fourth wave of COVID-19 in Canada, but with the presence and power of vaccination. Other usual respiratory viruses may also re-surface at this time. 

As a result, COVID-19 vaccines and influenza vaccines are recommended for age-eligible Canadians.

We should strive to remain flexible, and attentive at this time. Communication with the frontline workforce will also be very important for businesses.

Guidelines and rules may change in different jurisdictions at different times, so it is important to keep on top of your provincial or territorial public health guidelines and orders. Every leader will also need to be prepared to be flexible and adaptable in their own business setting. For example, we still need to treat COVID-19 infections in workplaces seriously. Supporting people to stay home when ill will protect others and the viability of the workforce. Vaccines are proving to be incredibly effective at preventing severe disease and death, but even as good as they are, they do not offer 100% protection for every person so there can still be a few rare cases of infection in those who have had their vaccines. 

This is great time to bolster or fine tune communication channels within workplace settings. Think carefully about how you want to communicate when a change in direction in your setting may be necessary. How will you let everybody know if change in the work setting is required? How will you talk about it? What if you need to get a message out quickly and efficiently and have people engaged in the conversation? 

JB: How do we keep people engaged when so many might be sick and tired of everything we’ve been doing and they just want to get back to normal?

RH: I think this will boil down to efficient and honest communication. Ideally, we let people know in advance when change is coming. In work settings, it will be good to celebrate changes such as opening some of the activities that people used to enjoy at break time or allowing people more flexibility to visit in person, but it may also be wise to alert people to the fact that it is possible at times they may have to temporarily revert to some of the old methods – a sort of “standby” period. 

Reminding people of the power of vaccination to get us all back to normal activities safely can also help. Try to assist those who may feel uncertain or hesitant about vaccines to learn more from trusted resources to help them reach their goal of moving past the pandemic time.

If there have been pandemic modifications made to breakroom spaces or schedules (to reduce crowding in poorly ventilated settings for example or to improve access to hand cleaning) then consider engaging the team in making decisions about what changes might be helpful to keep over the longer term.

JB: Is it okay to do more than the public health guidelines or rules say to do?

RH: Yes, it is okay, and I think we really need to foster a culture that lets that happen. For example, if people choose to wear a mask and it doesn’t interfere with their work or other personal protective equipment for other tasks, then why can’t they wear a mask?

It’s been very interesting through the pandemic, because even in businesses where people were accustomed to seeing masks, there were stories of people saying they felt ridiculed or made to feel silly for wearing a mask, and that clearly should no longer be the case since a mask can protect someone else.

Every business also needs to consider carefully how they support people to speak honestly and stay home when they’re ill with a contagious respiratory illness. All it takes is one contagious person to infect many other workers and their families and so on. One thing we’ve seen is that a culture of presenteeism when ill with a communicable disease can and does cause harm and unintended consequences.

JB: From an OH&S standpoint, how can a business manage a workforce with both vaccinated and unvaccinated people?

RH: The first thing, I would say, is that this is a very good time to bolster vaccination of the workforce. There are some great examples of industries and businesses across the Prairies doing this already.

For example, I was asked this spring if I could help promote confidence amongst a company’s workforce as someone who can speak to vaccines and the science around them. Taking the time to address questions or concerns of those who may have questions or feel hesitant about vaccines is time well spent. Research shows that people who are hesitant or uncertain are not necessarily against vaccination. Education can help.

When not everyone is immunized in a community, and knowing that not everyone has an immune system that allows them to respond optimally to the vaccines, reminds us that the virus can still enter a worksite because this virus hasn’t gone away. 

Some businesses are looking toward incentives for workers to be immunized, or allowing time away from work in order to obtain vaccine doses; and some are exploring making vaccines a condition of employment. Every industry should be looking for ways to learn what barriers to immunization might exist for people in their workforce and exploring ways to ensure workers have access to vaccines. Facilitating access to trusted resources to assist those who are uncertain about vaccines to feel confident and proceed with immunization can also help.

JB: When should or could we expect the COVID-19 virus to become just one of the ‘usual suspects’ in our repertoire of respiratory viruses? Do we want to get to that point? 

RH: Ideally, we would like to just drive COVID-19 out of here. If everyone the world over were safely vaccinated quickly so that the virus didn’t have a chance, that would be optimal. However, we need to be prepared for the possibility that the virus will stick around and persist season after season like many other illnesses do.

While public health measures are always available to us as tools, the hope is that vaccination will eventually take the edge off this viral infection by reducing severe disease and death to the point where we can use vaccine together with basic hygiene measures such as respiratory etiquette and handwashing alone for prevention.

The challenge will remain though for those people who can’t be immunized, or for those whose immune systems are weak so they do not respond well enough to the vaccines for protection. We currently face this challenge with influenza too. It reminds us of the importance of taking care to distance/mask and stay home when ill for the protection of others if even ill with influenza-like symptoms such as fever and cough. 

The next four months will be telling.

JB: As a physician working in the field of infectious diseases, vaccines, and workplace health and safety, what words of wisdom can you offer to our readers? 

RH: The world has seen on average two to three pandemics per century, but this one in particular makes history because past pandemics have been caused by influenza viruses whereas this pandemic was caused by a novel coronavirus instead, and it posed new scientific challenges.

COVID-19 is a serious disease, and we are all collectively seeing science and public health guidance evolve in real-time; but the virus has only been half the story. This has really been a story about people and how we communicate, how we succeed or fail in working together, and how we navigate political, business, and social ways of life.

We’ve learned a great deal about how we can better protect workplaces, workers, families, and communities in the face of communicable diseases including the important role for industry to support vaccination, and endorse the efforts of public health, science, and medicine. Business leaders need to have a voice and if we can partner to do this we will be stronger.