What the end of the COVID emergency means for Canada

The World Health Organization has ended the global COVID-19 emergency, citing increased immunity, fewer deaths and less pressure on hospitals. But while the situation with the virus has improved worldwide, it has also exposed major issues with Canada's health-care system.

Canadian experts said Friday that regardless of WHO's decision, COVID will remain a challenge to public health for years to come and has left lasting scars on the health-care system.

Dr. Bonnie Henry, British Columbia's provincial health officer and chair of the Council of Chief Medical Officers of Health, told CBC News that while the emergency phase of the pandemic is ending, COVID shed light on problems in long-term care and hospitals that need to be addressed.

"We have to pay attention to ensuring that we have that surge capacity in our health-care system," she said, adding that COVID also exposed "basic societal inequities" around pay and staffing in the system.

"This is another virus that is in our communities, it's going to be with us for a period of time and it adds to that baseline number of people that are going to require hospital care periodically in our community," Henry said. "So we need to add that on top of, and not go back to, the very stretched system we had before."

The pandemic, which was first declared an international crisis by WHO, the United Nations' health agency, on Jan. 30, 2020, resulted in unprecedented lockdowns, economic upheaval and the deaths of at least seven million people worldwide and more than 52,000 people in Canada.

But the death toll is likely much higher than reported, and WHO estimates it could be more than 20 million globally.

"It's with great hope that I declare COVID-19 over as a global health emergency," WHO director general Tedros Adhanom Ghebreyesus said Friday. "That does not mean COVID-19 is over as a global health threat."

Following WHO's declaration, the Public Health Agency of Canada said in a statement that it will "continue its work with provinces and territories to implement a long-term, sustainable approach to the ongoing management of COVID-19."

WATCH | COVID-19 no longer a global health emergency, WHO head says:

WHO says COVID-19 is no longer a global health emergency

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World Health Organization director general Tedros Adhanom Ghebreyesus says population immunity has increased from vaccination and infection, and the pressure on health systems from COVID-19 has eased.

Lessons for a fragile health-care system

COVID hospitalizations still remain stubbornly high in Canada, with 2,881 hospital beds occupied by COVID patients across the country, according to the latest federal data, despite continuing to decline since the beginning of the year. But the numbers are a far cry from where they once were.

"We had some very, very challenging times with COVID," said Dr. Isaac Bogoch, an infectious diseases physician at Toronto General Hospital, recalling instances where adults had to be treated in pediatric wards and authorities built tents outside ERs to treat the overflow of patients in the spring of 2021.

He said that WHO's declaration should be treated as an opportunity to reflect on the country's flawed health-care system and how it can be improved going forward.

In many parts of the country, emergency rooms remain under immense strain despite the decline in COVID hospitalizations.

"It's a patchwork of many different systems that don't necessarily fit well together," Bogoch said.

"Many people working in health care would have told you this years before the pandemic, but it was exposed during the pandemic."

Dr. Prabhat Jha, a professor of global health epidemiology at the University of Toronto's Dalla Lana School of Public Health, said the global reality is that we now have stronger population immunity from a combination of infection and vaccination — but the crisis isn't over.

"We still have incredible challenges when it comes to our health-care system, particularly when it comes to primary health," he said, adding that vaccination infrastructure needs to be maintained in Canada for COVID and other viruses to prevent a further burden on hospitals.

"What is needed is to strengthen public health systems, strengthen the surveillance, the ability to get out rapid tests and vaccination. In peacetime, you don't let the entire infrastructure erode."

More than 77 per cent of Canadian adults and close to 90 per cent of young adults (aged 17 to 24) are estimated to have previously had the disease as of mid-January, according to national blood donor data from the federal government's COVID-19 Immunity Task Force.

Those high levels of infection, combined with the more than 83 per cent of Canadians who've received at least two doses of a COVID vaccine, better treatment access and less severe infections than previous strains, have led to stronger immune protection against a virus that continues to spread globally.

But only about two thirds of Canadians over the age of 60 have been previously infected, and fewer than 20 per cent have received a shot in the past few months, meaning there is still a significant part of the population vulnerable to infection and hospitalization.

Past and future challenges

Experts have warned that the pandemic's ongoing burden on the health-care system will be felt for years to come, with long COVID affecting a subset of those infected, and delays for cancer screenings and surgeries causing massive backlogs in Canada's system.

Dawn Bowdish, an associate professor at McMaster University in Hamilton and a Canada Research Chair in Aging and Immunity, said maintaining vaccination rates, particularly among more vulnerable populations, will be crucial going forward.

"COVID is still worse than the flu," Bowdish said. "COVID is in now the top three causes of death and will probably persist — and that means just like the flu will have surges where health-care capacity is at its maximum and there will be compromises for other treatments."

B.C.'s Dr. Bonnie Henry said that while the end of the emergency phase of the pandemic wasn't unexpected, it's an emotional reminder of how challenging the last three years have been for Canadians.

"Adversity introduces us to ourselves, and I think across this country, across this province, people have been generous and kind and resourceful, and brave," Henry said, adding that Canadians stepped up to get vaccinated across the country when it mattered most.

"Let's use this as another opportunity to move forward with coming together and not being polarized, not trying to make this an issue. Let's remember the things that we learned through this about how we can support each other."