Long a pandemic leader, Nova Scotia is now a COVID-19 hot spot

Nova Scotia's past success at managing the COVID-19 pandemic is also one of the reasons why its daily case counts have never been worse, say two infectious disease experts.

The province has long been lauded for its handling of the pandemic, but daily case counts from the highly transmissible Omicron and BA.2 variants have been rising since late February. They have accelerated dramatically since the Nova Scotia government lifted most public health restrictions on March 21, including gathering limits and mandatory masking in most public places.

"The fact that it continues to go up and the percentage of people that are positive in that group means that there's really a lot of virus out there," said Dr. Lisa Barrett, an infectious diseases doctor and researcher at Dalhousie University in Halifax.

Last Thursday, the most recent COVID-19 weekly reporting date, the province announced an average of almost 1,000 new daily cases, an all-time high since the pandemic began.

Barrett said the lack of mandatory masking rules in most settings combined with a large swath of the population without a previous COVID-19 infection has made Nova Scotia especially vulnerable.

"All those people who hadn't really been exposed before are getting infected, pretty much all at once, which was really what we wanted to avoid," said Barrett.

As well, despite high two-dose vaccination rates in Nova Scotia, booster uptake hasn't been as strong, said Barrett. Among Nova Scotians over the age of 18, only 63.9 per cent have had a booster dose, according to the provincial COVID-19 dashboard.

Officials in Nova Scotia have stressed that the emphasis should be on COVID-19 hospitalizations, not case numbers. But experts point out that as infections rise, hospitalizations are sure to follow. 

"The problem is that by the time they're going up, it's too late," said Tara Moriarty, an associate professor and infectious diseases researcher at the University of Toronto.

While the official new daily case count for Nova Scotia was around 1,000 as of last Thursday, Moriarty believes it's more in the neighbourhood of 10 times that. She's developed a public spreadsheet that uses modelling to provide a more accurate picture of the COVID-19 situation in Canada.

"Since we've really started testing a lot less, I and others have been trying to develop methods that give us a sense of how many infections are actually occurring on a daily basis and how many hospitalizations, for example, ICU admissions and deaths we might expect from those," said Moriarty.

She said data reporting is poor across the country, so it's difficult for people to accurately assess what the risk levels are of contracting COVID-19.

"It's really quite serious," she said. "And a lot of Atlantic Canada has been far worse off over the last month than most other provinces."

That could extend to North America.