Why navigating your COVID risk is now harder than ever

This is an excerpt from Second Opinion, a weekly health and medical science newsletter. If you haven't subscribed yet, you can do that by clicking here.

Figuring out where you're most at risk of catching COVID-19 is more challenging than ever in Canada's Omicron-fuelled sixth wave, and tried-and-tested strategies for avoiding infection are proving less effective in everyday life.

The rapidly spreading BA.2 subvariant has been evading all of our layers of protection — from vaccines to masks — and fuelling a surge of COVID-19 levels across Canada during a time of few restrictions.

But while attempting to avoid COVID-19 risk entirely isn't realistic, abandoning strategies that have worked to lessen the impact of the virus isn't either — making this phase of the pandemic incredibly difficult to navigate.

"We have not experienced what it's like to live with this virus while we are doing this little to stop it," said Dr. Jeremy Faust, an emergency room physician at Brigham and Women's Hospital and a Harvard Medical School instructor who recently wrote about navigating risk. 

"Never until now have we been in a situation in which we have the least amount of protection against infection and these variants that are just flabbergastingly contagious." 

Faust says because everyone has a different risk threshold in day-to-day life, trying to navigate the pandemic based on your presumed best interest is a "dead end" because many people are unlikely to have judged the situation correctly.

"We might be completely correct one day and be safe and be completely incorrect the next day and be either personally at risk or putting someone else at risk," he said. "And it's this variability that makes your head spin if you stop to think about it."

Dr. Lynora Saxinger, an infectious diseases physician and associate professor at the University of Alberta in Edmonton, said part of the problem with Omicron is that it punches through all our layered protections "much more effectively than anything has before."

"All of those layers still reduce your risk, it's just that the assault on the layers is a lot more aggressive right now," she said. "It's like there's a lot more shots on goal."

Saxinger said that even though Canada is vastly undercounting current case numbers there is still a "forest fire of COVID" raging across the country, with transmission signals recently rising in Alberta, Ontario, Nova Scotia, Saskatchewan and Manitoba despite limited testing.

"The risk of infection has gone up markedly over the past three months," said Erin Bromage, an associate biology professor at the University of Massachusetts Dartmouth who researches infectious diseases.

"And it's getting harder for those who have avoided infection up until now to continue avoiding infection."

Canada's Chief Public Health Officer Dr. Theresa Tam said this week that average daily case counts, test positivity rates and wastewater signals are all signalling growing transmission across the country that requires the "layering of precautions" to drive infection rates down.