Dr. Ali Ghahary | Family Physician

For almost two years, British Columbians have had to take certain measures to keep themselves, their families, and their communities safe from COVID-19 – including testing, physical distancing, limiting or avoiding non-essential services and travel, mask-wearing, and most recently, vaccines. Now, another layer of protection will soon be coming into effect. Starting September 13th, and by order of Provincial Health Officer Dr. Bonnie Henry, British Columbians aged 12 and older will be required to show proof of at least one dose of COVID-19 vaccination (two doses by October 24th) if they want to access certain services, businesses, and events.

“Where will I be required to show proof of vaccination?”
You will need to show proof of vaccination if you want to access the following:

• Indoor ticketed sporting events, concerts, theatre, dance and symphony performances
• Indoor and outdoor dining at restaurants, bars and pubs
• Nightclubs and casinos
• Movie theatres
• Gyms (including high-intensity group exercise), recreation facilities and pools
• Indoor organized recreational classes and activities
• Indoor organized gatherings (i.e., weddings, funerals, parties, meetings, workshops)
• Post-secondary on-campus student housing

“How will I be able to access my vaccine card?”
Starting September 13th, British Columbians will be able to visit a secure website to access their vaccine card. From there, you will be able to save your vaccine to your smartphone for easy access and show it when accessing any of the aforementioned services, businesses, or events. If you do not have access to a smartphone, British Columbians will also have the option of receiving a paper copy of their vaccine card. In order to access your vaccine card, you will need to provide proof of identity – including your name, date of birth, and personal health number. To prepare and confirm your immunization records, it is recommended that you register for Health Gateway. (This secure website also provides you with information on healthcare visits and recently filled prescriptions.) If you believe any of your information on Health Gateway is incorrect, you should call 1-833-838-2323 (available 7 days a week from 7 AM to 7 PM PST.)

“Do I still need to show proof of vaccination if I’m visiting from outside of British Columbia?”
If you are visiting British Columbia from another province or territory, you will be required to show valid government identification from that province or territory in addition to an officially recognized vaccination record. If you are an international visitor, you will need to show proof of vaccination used to enter Canada, in addition to showing your passport.

“What if I cannot get (or am not yet fully) vaccinated, or do not want a vaccine?”
Because this is a temporary measure to help British Columbians get through this risky period of COVID-19 – particularly with the highly contagious and rapidly spreading Delta variant – Dr. Bonnie Henry has stated that there are no plans at this time for exemptions to be made for unvaccinated individuals who want to access discretionary services, businesses or events where the vaccine card will be required.

“If I’m not yet vaccinated but want to get a vaccine, where do I go?”
British Columbians who are not yet vaccinated (or not yet fully vaccinated) and want to be, can register for their vaccine by clicking here.

“Will I need to show proof of vaccination each and every time I want to access these things?”
For the time being, yes, you will be required to show your vaccine card when wanting to access discretionary services, business or events. The vaccine card program is set to expire on January 31st, 2022; however, it is subject to extension depending on where things are with COVID-19 in our province at that time.

When it comes to COVID-19, it is a virus that can affect individuals of all walks of life – regardless of age, gender, or where they live in the world. However, what we’ve also learned since living with this virus for the past 18 months is that there are certain individuals who may be at increased susceptibility for COVID-19 than others. While age is something that certainly plays a role (with those over the age of 60 being the most impacted by this virus with severe illness, hospitalization and death), we also know that individuals with certain pre-existing medical conditions are also more likely to contract COVID-19 and develop severe illness as a result – including the following:

• Those who have cancer or are receiving cancer treatment
• Chronic kidney disease
• Chronic lung disease (i.e., asthma, COPD)
• Diabetes (type 1 or type 2)
• Neurological conditions (i.e., dementia)
• Heart conditions (i.e., heart failure, coronary artery disease, hypertension)
• Liver disease
• HIV infection
• Pregnancy
• Those who are immunocompromised
• Blood disorders (i.e., sickle cell disease, thalassemia)
• Obesity
• Those who are smokers (current or in the past)

To mitigate the spread of the virus, measures were put in place early on in effort to help decrease the spread of COVID-19 – such as physical distancing guidelines, limiting or closing non-essential services (including limiting the number of people allowed inside a business), mask mandates, and more. However, with vaccines now in the mix, this has allowed many of these restrictions to be loosened, businesses to reopen, and life to go back to a certain degree of normalcy – and while some individuals may feel comfortable going back to living their lives the way they did prior to this pandemic, not everyone may feel comfortable doing so just yet. For example, a friend or family member might invite you out to eat at a restaurant while you might instead prefer ordering in; or, you may have been working remotely through the pandemic and are now being pressured by co-workers to return to in-office work; or people may ask why you’re still wearing a mask despite being fully vaccinated. In cases such as these, it may be surprising to some to learn you aren’t taking the exact same measures as them when re-introducing yourself to what’s known as a “post-pandemic” world (despite the pandemic still very much being a significant factor – particularly with numbers on the rise again due to the highly transmissible Delta variant.)

In any event, what’s comfortable for one person may not be comfortable for someone else, and it is both important to not only set your own personal boundaries – but, in turn, also be respectful of the personal boundaries that individuals may set for themselves due to their own personal risk profile – especially if they do not align with your own; also taking into account that someone may have certain comorbidities that you are not aware of, which may lead to some hesitancy in things like not wearing masks, etcetera.

For some, setting boundaries can be difficult, but it’s important to note that any decision you make for yourself is the right one as you’re doing what you need to do to not only protect yourself, but protect those around you, and you should not feel guilty about wanting to ensure your own optimal health as well as the health of others. While one’s risk of developing COVID-19 decreases if they are fully vaccinated, the fact remains that vaccines are not considered 100% effective – there is still the potential for breakthrough cases – and one’s personal risk factor still needs to be considered. When being invited to a social gathering, the likelihood is that your friends and family miss you; but as you turn them down, they may feel as though you’re trying to intentionally avoid them which could lead to hurt feelings. This is why it’s also important to have a conversation about why you’re setting personal boundaries, and find other ways to continue to prioritize those friendships by offering alternative ways of socializing – such as having regular group video chats, as keeping those social connections are important – particularly for our mental wellbeing.

One of the most common questions that healthcare professionals are asked lately, is how can someone tell the difference between COVID-19, the common cold, and flu. While these are all considered respiratory illnesses, there are some differences in the way they are clinically diagnosed, as the symptoms of each illness will also slightly differ while sharing some similarities at the same time.

First, we’ll start with the common cold. Common colds are viral in nature, meaning that there are no antibiotics that will act as a magic cure, and you unfortunately just have to let nature take its course and deal with those aggravating (and sometimes uncomfortable) symptoms, such as nasal congestion and/or runny nose, and a sore throat. While it can be possible to develop a secondary infection as a result of having a cold, such as a sinus or ear infection (which, in this case, will require antibiotics), a common cold is not considered life-threatening and will generally go away on its own after one or two weeks with simple at-home treatment; such as drinking warm liquids (i.e. tea with honey), getting plenty of rest, and avoiding going to work/school when sick. For relief of symptoms such as nasal congestion, you can take an oral decongestant. There are also nasal spray decongestants available, but you should be careful to not use them frequently as overuse can result in rebound congestion.

Then there is the flu (influenza.) Symptoms of the flu include fever and/or chills, fatigue, weakness, body aches and pains, and headache…while it’s also possible to develop symptoms similar to that of a common cold. When it comes to the similarities between having the flu and COVID-19, they are similar in the way in which they are transmitted. For example, both the flu and COVID-19 can be spread from person to person via droplets (which occur as a result of an infected person sneezing, coughing, or even talking in close proximity to someone else, as well as an infected person touching surface, etc.) As for treating the flu, it can also not be cured with antibiotics. Instead, like a cold, treatment is focused on addressing the symptoms present in the patient, such as reducing fever. A vaccination is also available to help prevent you from getting the flu, as well as reduce the severity of symptoms should you still happen to develop the flu.

When it comes to COVID-19, symptoms that are more likely to occur include the following:

• Fever
• Cough
• Shortness of breath
• Difficulty breathing

In many cases of novel coronavirus, the aforementioned symptoms will be quite mild, while some individuals symptoms may not even be present (also known as being asymptomatic) and therefore they won’t even be aware they have the virus. If you do develop symptoms, even if you don’t think they are severe, it’s still important to self-isolate, as when you pass the virus on to someone else the severity of their symptoms could differ for them significantly from yours, particularly if they are considered high-risk (i.e. have a pre-existing/underlying condition.) In the event that your symptoms are severe, you should call 811 or your family physician’s office. If you develop an extremely high fever or have trouble breathing, you should call 911.

You’ve likely heard the term PPE – otherwise known as Personal Protective Equipment – talked about a lot in relation to COVID-19. PPE refers to protective clothing and other items, such as:

• Gloves
• Face masks (surgical masks, N95 respirators)
• Face shields
• Hair covers
• Goggles
• Gowns
• Other equipment designed to protect the wearer’s body from injury/infection

Because frontline workers, such as nurses and physicians, come into extremely close contact with patients who are ill, and because COVID-19 is an extremely contagious virus, these frontline workers need this protective equipment to not only protect themselves from developing the virus, but to also stop it from being passed onto others – such as co-workers, other patients they see, as well as from bringing it home to their loved ones. Along with hospitals and doctor’s offices, PPE is also used in clinical labs. There are also certain procedures in which there is a greater need for PPE to be used, such as intubation (in which a tube is inserted through the patient’s mouth and into their airway), as well as nebulizer treatments (in which medicated mist is delivered to the patients lungs via a machine.) These particular procedures can cause a larger amount of the virus to be dispersed into the air.

When wearing Personal Protective Equipment, this acts as a barrier between the person and the illness-causing viruses or bacteria. Because the easiest way for germs to enter your body is via the eyes, nose, and mouth (as well as when your hands touch these areas), PPE is designed to cover these areas of the face. There are also different types of Personal Protective Equipment that come with different qualities and capabilities, and there are very high standards for the way in which they are made. For example, they should be fluid resistant and leak protective, have a filtering capacity, as well as be resistant to tears and snags. When used properly with other infection control measures that are put in place (such as covering your mouth when you cough or sneeze, hand washing and use of alcohol-based hand sanitizer), PPE will help minimize the spread of infection from person to person. Using PPE effectively also means proper removal and disposal, which also prevents both the wearer and other individuals from infection.

One of the most common questions asked by the general public is if they, too, should be wearing any type of Personal Protective Equipment, such as masks or gloves – and the answer is yes. In British Columbia, the wearing of certain types of PPE, such as face masks, is mandatory in indoor public places – such as shopping malls, grocery stores, schools, libraries, as well as on public transit. By continuing to follow all public health orders and restrictions, you not only keep yourself and your loved ones protected, but also reduce the risk of spread of the virus in your community.

One of the most common questions that people are asking in relation to COVID-19 is, “What do I do if I think I have the virus?” It can be particularly difficult to self-diagnose based on symptoms, simply due to the fact that the symptoms associated with COVID-19 are very similar in nature to other types of illnesses such as the common cold or influenza. Symptoms, for example, that can include things like fatigue, fever, coughing, sore throat, nasal congestion, and general body aches and pains.

This is why, whether you have a confirmed case of COVID-19 or if you’re still awaiting test results, it is important that you self-isolate until your results are back and your symptoms have subsided. This means that during this time, you should not be going out to any public places. If you are in need of essential items like food or medication, you should text a family member, friend or nearby neighbour to see if they would be willing to pick up any necessities you might require and drop them off at your door. It is imperative that we follow the orders and advice put forth by our public health officials in order to prevent COVID-19 from spreading in our communities. In adhering to the rules, we will hopefully be able to get back to some semblance of normalcy sooner than later.

If you are exhibiting symptoms of COVID-19 and they are mild, you should closely monitor yourself. If you feel the need to see a physician, it’s important to note that you should not just go to your doctor’s office or nearest walk-in clinic. While this might be the easiest thing to do, it’s also a very risky thing – especially if you aren’t sure whether or not you have COVID-19. Instead, pick up the phone (or e-mail, if you are able to do so) your physician’s office. You will be able to discuss your symptoms with the staff and they will be able to advise you what, if anything, you should do. In many cases, several medical clinics across Canada have also now implemented other methods for their physicians to stay in communication with patients, such as via video and tele-visits, as there are also patients with other medical conditions who require care and need to be seen by their physicians regularly. Some pharmacies also have the option of having medication delivered to patients homes for those who have or are at risk of COVID-19 and do not want to risk going out in public.

If you develop symptoms that are more severe, such as tightness of the chest, cough (including coughing up blood) or trouble breathing, then it is recommended that you call 911.

Like any medication that someone might be prescribed, people will no doubt have questions about any potential side effects that may be attributed to them. That is also no different when it comes to the vaccines that are available to help prevent COVID-19. While there are certain risks that have been associated with the vaccines – most notably AstraZeneca and Johnson & Johnson, where there have been reported cases of rare blood clots associated with both – the vaccines are, overall, generally well-tolerated, and health officials worldwide continue to watch for any reports of adverse events associated with these particular vaccines (in addition to the Pfizer and Moderna vaccines) and act accordingly.

When it comes to side effects associated with the COVID vaccines, this is not unheard of. In fact, it’s more common to experience mild side effects as a result of receiving a vaccine than not. Among some of the most common side effects associated with the COVID-19 vaccines include:

• Pain or swelling around the site of injection
• Mild fever and/or chills
• Nausea and/or vomiting
• Headache
• General body aches and pains

These symptoms will usually develop within the first day or two following your vaccination and will typically last for up to 2 or 3 days (although in some cases they may last longer.) These symptoms are nothing to be alarmed about and are a sign that your body recognizes the vaccine and is developing an immune response – in other words, it’s doing what it is supposed to be doing. If you received the Pfizer, Moderna or AstraZeneca vaccine, you will also be required to receive a second dose for adequate protection from COVID-19. As such, you can expect to experience these same symptoms following your booster shot. However, it’s not uncommon for symptoms to be more intense after receiving the second vaccination. This is because the body’s immune response following the first dose is usually quite strong – and, as a result, the cells in your body are already prepared to respond. That being said, not everyone will develop side effects to the vaccine – however, this doesn’t mean that your immune system is not responding. Whether someone does or doesn’t develop side effects generally depends on how robust one’s immune system already is. For example, a younger person’s immune system tends to be more robust than that of someone who is elderly – therefore, side effects may be felt as a result.

If your side effects persist after 7 days, you should consult with your physician. Furthermore, while these mild, temporary flu-like symptoms are to be expcted, COVID-19 vaccines do not cause side-effects such as sore throat, couching, or chest pain – and these could be indicators of other illness, such as a viral infection, or even COVID-19 itself. As it takes several weeks before your body to become protected by the vaccine, it’s still possible to develop COVID-19 even after you’ve been vaccinated. Therefore, if you are experiencing any other symptoms, you should book a COVID-19 test and self-isolate until you receive your results and you are without symptoms.

On March 11th, 2020, the WHO (World Health Organization) officially declared COVID-19 a global pandemic. Below is some insight into how the virus has impacted Canadians, how it has shaped the way we live our lives, how vaccines are now crucial in helping prevent transmission, and what we can take from everything we’ve learned in the last year as we move forward.

First Case of COVID-19 in Canada

The first case of SARS-CoV-2 was found in a Toronto man who had recently travelled to Wuhan, China – the epicentre of the COVID-19 outbreak – and was announced by Health Canada on January 25th, 2020. As a result, new screening measures were implemented at several Canadian airports (Vancouver, Toronto and Montreal) for any passengers who were exhibiting flu-like symptoms.

On January 28th, 2020, British Columbia became the second Canadian province to confirm a case of COVID-19 – also related to travel. On March 5th, 2020, B.C. announced its first case of community transmission, followed by a State of Emergency declaration on March 18th (which remains in effect.)

Social Connections, Shutdowns and Travel

As scientists learned more about COVID-19, it was discovered that one of the easiest ways the virus was transmitting was through having close contact with an infected individual – through respiratory droplets and aerosols that are created when the infected person talks, coughs, sneezes, shouts, sings, etc. While we were all used to having close social connections with others – whether at work, home, school, or elsewhere in the community – those very social connections had to be significantly limited, with the recommendation that individuals keep at least 6 feet (2 metres) apart from others. As the virus progressed, health orders were put in place across many Canadian provinces and other parts of the world that limited or restricted social gatherings and who we could spend time with.

Many popular events, such as Vancouver’s PNE (Pacific National Exhibition), as well as live concerts, did not go as planned and had to be cancelled or postponed indefinitely, while retailers closed temporarily, and restaurants switched to a takeout-only model. For a list of British Columbia’s current restrictions, click here.

When it comes to travel, several provincial and territorial restrictions are in place along with other Canadian border restrictions. In British Columbia, it is recommended that non-essential travel be avoided for the time being.

The Impact on Mental Health

With certain restrictions in place, many individuals found the lack of social connection with others to have a significant impact on their mental health – exacerbating things like stress and anxiety, as well as causing individuals to feel isolated. As a result, Canada saw a significant uptick in requests for mental health services. If you or someone you know is struggling with their mental health, the Canadian Mental Health Association has a list of national programs and services available on their website at CMHA.ca.

Vaccines

The vaccines created to help prevent the spread of COVID-19 were some of the quickest that any vaccine had been developed. While there are several different types of COVID-19 vaccines, those currently approved for use in Canada include the Pfizer-BioNTech vaccine, Moderna vaccine, the AstraZeneca vaccine, as well as the Johnson & Johnson vaccine – with others under review. Each province has its own vaccine plan. You can find British Columbia’s vaccine plan, and information on how to register for your vaccine, by clicking here.

Since the start of the COVID-19 pandemic, scientists all over the world have been hard at work studying the virus, how it impacts individuals of all ages, races and genders, and creating vaccines to help prevent infection and transmission.

To date, Health Canada has approved the use of the following vaccines:

• Pfizer-BioNTech
• Moderna
• AstraZeneca
• Johnson & Johnson

Pfizer-BioNTech and Moderna Vaccines

Both the Pfizer-BioNTech and Moderna vaccines are what’s known as messenger RNA vaccines (also referred to as mRna.) These particular vaccines work by teaching our tells to create proteins which trigger an immune response. Once that immune response is triggered, your body will then create antibodies which are ultimately what help fight off the COVID-19/SARS-CoV-2 infection should the virus enter your system.

Both the Pfizer-BioNTech and Moderna vaccines require the patient to receive two injections (a priming dose, followed by a booster shot) for full efficiency. If you receive the Pfizer-BioNTech vaccine, the recommended interval between doses is 28 days; while 21 days is recommended for those who receive the Pfizer-BioNTech vaccine. However, many parts of the world have extended intervals between doses anywhere from 42 days to 4 months.

AstraZeneca Vaccine

Unlike the Pfizer and Moderna vaccines, which need to be stored at specific temperatures (at least -60ºC – -80ºC), the AstraZeneca vaccine does not require any special storage and can simply be stored inside of a standard refrigerator for as long as 6 months, making shipment easier.

The AstraZeneca vaccine is what’s known as a genetically modified adenovirus-vectored vaccine which also carries spike protein. Similar to the Pfizer and Moderna vaccines, when the AstraZeneca virus is administered the body will then build up a strong immune response against this spike protein and produce antibodies, protecting you from COVID-19.

Johnson & Johnson Vaccine

Compared to the Pfizer, Moderna and AstraZeneca vaccines which all require two doses – those who receive the Johnson & Johnson vaccine will only require one. Like the AstraZeneca vaccine, the J&J vaccine is also a viral vector-based vaccine which produces spike protein and helps your body build an immune response.

Vaccine Side Effects

While there have been some adverse effects associated with these and other vaccines, they are generally safe and well tolerated. Typical side effects that can occur as a result of receiving a vaccine include things like pain at the site of the injection, fatigue, headache, nausea, vomiting, fever, and chills. These side effects are usually temporary and generally resolve on their own after a day or two.

When Can I Get My Vaccine?

Each Canadian province has different rollout systems for the vaccine. British Columbia is currently in Phase 2. To learn more about British Columbia’s immunization plan and vaccine eligibility, click here.