NWT Launches RSV Program Early, Bivalent COVID Boosters To Avoid Potentially ‘Severe’ Season

NWT Launches RSV Program Early, Bivalent COVID Boosters To Avoid Potentially ‘Severe’ Season

As flu season approaches, the NWT health department is moving early to combat a combination of viruses: RSV, COVID-19, and influenza.

Dr. Kami Kandola, director of public health for NWT, issued a public health advisory Tuesday for what she warned could be a “serious” season for respiratory viruses.

She said her office has begun to see laboratory-confirmed cases of RSV, or respiratory syncytial virus, in young children. She is also seeing more serious respiratory problems and hospitalizations of young children under the age of five, and the territory has now recorded its first lab-confirmed flu case of the season.

That means his department will launch its antibody program to protect babies at risk from RSV on Nov. 1, earlier than usual. Influenza vaccines are also available, and health workers have begun giving bivalent COVID-19 vaccines to anyone over the age of 18, with more bivalent options on the way.

Kandola joined CBC’s Loren McGinnis on Thursday morning on the pioneer to discuss the program.

This interview has been edited for clarity and length.

Let’s start with RSV. Can you explain what it is and why you are raising your concern now?

RSV is a respiratory virus and can usually present with mild symptoms for most: fever, runny nose, cough. But in young children, especially those under the age of two, it can lead to pneumonia and inflammation of the small airways, which we call bronchiolitis, and can lead to hospitalizations.

What worries me is that in the Northwest Territories, we usually have a limited RSV season: it’s in the winter months. We usually start seeing RSV in December and then it starts to fade in April. What was unusual last year is that in our wastewater monitoring, we were seeing RSV through the end of July, and RSV is starting early now. We have seen cases since October. So our RSV season is starting early and we have already seen some hospitalizations.

We are implementing our Synagis program, which is a monoclonal antibody. We’re targeting the very, very vulnerable, which is our premature babies, babies with chronic lung disease, and those with significant unstable heart disease. So we will implement it on November 1st.

The season lasted a long time, where it stayed at the end of last season, and now it’s starting early. Do you have any idea why that might be?

This is not just happening in the Northwest Territories. We’ve seen it in the US for two years, we had COVID-19 measures: we had mandatory masks, limited gatherings in terms of size. So we had all these precautions that protected us from the COVID-19 virus, but it also protected us from the flu, the common cold, and RSV. Now that we have lifted the measures, children are going back to kindergartens and schools, and they are interacting. And now they’re experiencing these viruses all at once, at the same time.

In terms of RSV, based on how it spreads, what should we do?

Take the same precautions that will protect you from the flu, the common cold, and COVID. First of all, parents, if your child is sick, please stay home until he or she is better so that he or she doesn’t spread it to day care or to other children. Practice good hand washing. Wear a mask when appropriate. Cover your cough and sneeze.

Unfortunately, for RSV, there is no vaccine yet. But you can still get vaccinated against influenza and you can get vaccinated against COVID-19.

There are also protective factors. Breastfeeding is a protective factor and mothers can transmit the antibodies to their children.

He mentioned a medical intervention that he will implement on November 1 for those most at risk. Can you explain what that is?

They are preformed antibodies, Synagis, and we use them for our highest risk children. We implement it as a preventive measure, to avoid serious complications of RSV, which are pneumonia, bronchiolitis and hospitalization.

We typically never roll it out as early as November 1st and tend to stop around April or May. But this year, we stopped late and are now rolling it out early so that those babies who are most at risk of hospitalization can get this preformed antibody early. That way, if they are exposed to RSV, they have these antibodies to fight it off.

This antibody has to be provided once a month.

How has the removal of public health restrictions affected our risk of severe respiratory illness, influenza, and things like RSV?

If you look at the reason why we started wearing masks, and we’re looking at our COVID-19 infections, if you look at our sewage monitoring, COVID-19 has started to decline in our sewage. I feel like we have more population immunity. So with regards to COVID-19, as more and more people have been exposed, we’re seeing less and less.

The problem with influenza and RSV is that in the last two years we hardly saw any influenza. There were no hospitalizations for influenza. RSV was relatively silent, it wasn’t causing as much of a problem as we anticipated at this point, so basically kids don’t have the same immunity. They were pretty much protected, so this fall season, as we go back to our usual approach to the winter season, there are a lot more people who don’t have immunity to RSV. They will then pick it up and spread it quickly.

With the flu, the good news is that we are implementing flu clinics. We really encourage parents to have their children vaccinated. People often think of the elderly or those with chronic illnesses, but everyone should get a flu shot. It is available free of charge, and the only group that is not eligible for that vaccine is those under six months of age.

Can you talk about the launch of the bivalent COVID vaccine?

On October 25, we launched the bivalent Moderna vaccine, which protects against BA. 1 and has the ancestral strain. That is available as a booster for everyone over the age of 18.

Starting in early November, we’ll also have Pfizer’s bivalent available, and that’s BA. 4/5 Strain and the Ancient Strain, and will be available to residents ages 12 and up.

It is a bivalent that is only given as a booster. It must have been at least six months since you received your last dose of a COVID-19 vaccine and at least three months since you were infected with COVID-19.

What’s important is that… some people are at particularly higher risk of serious illness or outcomes than others. So if you’re an older adult, especially if you’re 60 or older, if you haven’t been vaccinated or haven’t had a booster or have been partially vaccinated, you’re at higher risk. If you are pregnant, have moderate or severe immunosuppression, and anyone who has chronic conditions, such as receiving an organ transplant, undergoing cancer treatment, high blood pressure, heart disease, lung disease, kidney disease, liver disease, are at higher risk, as well as those with dementia, stroke, diabetes, and those who are severely obese with a body mass index of 40 or more.

Anything to add?

We have all learned in the last two years what healthy habits are. And so keep practicing your healthy habits. Stay home if you are sick, do not spread it to others. Bring your vaccinations up to date and we’ll get through.

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