Health experts predict gradual return to normal, but with caveats

"We are winning."

That was the message from Dr. Vera Etches,Ottawa's medical officer of health,during a Thursday conference call with reporters aboutthe city's COVID-19 situation.

The optimistic statement came the same day hospital officials in Ottawa declared thatfor the first time in a year and a half, theyhad not a single COVID-19 patient in their care.

Every key indicatorof community transmission in the city continues to plunge, while the number of eligible residents who are fully vaccinated climbs to new heights each day and had neared 50 per cent by late last week. Coverage among those over 18 reached 52 per cent on Friday.

The days of lockdowns are behind us, I think that's pretty much certain.- Raywat Deonandan, University of Ottawa

"The vaccine is winning out over transmission of COVID right now," Etches announced.

And yet despite the victorious tone, health officials across the region, including Etches, remain cautious.

While Ontario announced Friday it wouldenterthe next step of its reopening plan ahead of schedule, many of the restrictions introduced to slow the spread of the virus remain in place for the moment:indoor dining is still off limits, theatres and gyms are still shuttered, and large public events areon hold.

• Ontario is entering Step 3 of the province's reopening plan next week. Here's what will change

As close as we're getting to something resembling the pre-pandemic normal, we're not there yet. Herd immunity remains an elusive target, and a moving one.

"It's too early to say exactly when we'll be able to have confidence that the immunity is sufficient to be able to really go back to no [precautions] at all," Etches said."We need to continue these protections until we're confident that the level of immunization and immunity from infection in our population is sufficient."

Delta variant, kids under 12 cause for concern

Two major concerns continue to nag public health officials: the unpredictability of new variants of concern likethe now-dominant delta variant, and the portion of the population that remains unvaccinated.

Notably, that includes children ages 5-11 for whom vaccines haven't yet been approved, but who will almost certainly be crowding back into classrooms come September.

"Herd immunity is going to be elusive," said Dr. Robert Cushman,acting medical officer of health with theRenfrew County and District Health Unit, who recently urged younger residentsto do their part by getting vaccinated.

Cushman believes three-quarters of eligible Renfrew County residents will be fully vaccinated within the next two weeks, but that still leaves a worrying number of unvaccinated adults and children.

"I don't want to be a pessimist, but this is going to be with us for some time," he said.

By "some time," Cushman means we could be battling new variants and getting booster shots for the next three to five years.

"So it's not back to normal, it's back to a new normal," he said."Unfortunately, it's going to be some time before you can really feel secure in a setting with a large number of people."

Room for optimism

For Dr. Paul Roumeliotis, medical officer of health with the Eastern Ontario Health Unit, getting vaccines approved for children five and over is a crucial step toward reaching that elusive 90 per cent coverage and gradually reopening the region in the fall.

"That's why I'm saying, as we get into the fall months, it will become more abundantly clear that we have a bigger herd immunity effect. Because I'm very confident that we will have vaccines for five and above," he said.

Once that younger cohort is vaccinated, Roumeliotis believes the situation will start to improve dramatically.

"I believe that between now and the fall we'll have significant progress in that regard, and if all goes well between the fall and Christmas we'll be headed to what we call sort of almost pre-pandemic normalcy," he predicted.

So what will that look like on the ground?

For Roumeliotis, it will mean no masking or physical distancing requirements, but "withcautions obviously for people who are symptomatic." Even then, health officials will remain"hyper-vigilant" against new variants, he said, and certain healthymeasures like frequent handwashing are likely here to stay.

Light at the end of the tunnel

In an interview last week, University of Ottawa epidemiologist Raywat Deonandansaid he too can see the light at the end of the tunnel, but reaching it will requirekeeping precautions in placeuntilwe reach that magic vaccination target of 90 per cent.

It's a goal, Deonandan said, that will be difficultto achieveuntil children under 12 are immunized.

"Am I optimistic? Yes, because we kind of know what needs to be done," Deonandan said. "We have it in our power to control the epidemic if we do these things."

While Deonandan oncethought mandatory masking would be over by year's end, he's now a little less optimistic. Still, he believes we're on the right path toward a wider reopening.

"The days of lockdowns are behind us, I think that's pretty much certain," he said.

"Restaurants will be being used businesses will be open, people will be going to work more, the streets will be full of people and schools will be open for sure. It won't be normal though. You won't be seeing normal until Christmas maybe."