In 2020, Canadian life expectancy declined for the first time in living memory. Between 1950 and 2010, we had gained a remarkably consistent average of 2.2 years of life expectancy with each passing decade. That declined somewhat since 2010, likely due to increased income inequality, but remained positive until dropping by an unprecedented 0.6 years in 2020 due primarily to high COVID mortality. While it will be another two or three years before Statistics Canada publishes the 2021 and 2022 figures are published, considering that less than 600,000 Canadians were infected in 2020 (a number which mushroomed to 1.6 million in 2021 and some 26-30 million in 2022) life expectancy will likely fall further in those years.
There has been increasing evidence that viral infections play a significant role in triggering the persistent, systemic inflammation which characterizes a wide range of hard-to-treat conditions such as chronic fatigue syndrome, the symptoms of which overlap those of long COVID. While this syndrome remains ill-defined and poorly understood, a recent Statistics Canada survey of previously infected adults found that 15% of respondents had experienced continuing symptoms three or more months after their infection. The more severe the initial symptoms, the greater of likelihood of long COVID manifesting.
The rapid and continuing evolution of new families of Omicron variants which are ever more adept at evading the immunities which we have gained from vaccinations, prior infection or both has very severe implications for our society and economy. Now that 70-80% of Canadians have already experienced a COVID infection and most of the rest will likely succumb sometime in the coming months, 15% with long COVID could soon amount to some 5 to 6 million people.
Recent large-scale studies have confirmed that mortality rates, hospitalizations and major organ system dysfunctions six months after one’s most recent COVID bout are two to three times higher in those for whom it was their second. While the number with three or more bouts is still very small, severity appears to increase with each. Given that even those whose most recent bout was BA.5 will be vulnerable to reinfection by one or more of the newest variants, Canadians can therefore expect to suffer between one and three COVID bouts every year until and unless a vaccine is developed and distributed which can protect against all coronaviruses. The dreadful implication is that a large and increasing proportion of Canadian will suffer ever-more-debilitating long COVID symptoms. Sadly, there has been no sign of any level of Canadian government preparing for this eventuality.
Currently available data is woefully insufficient for any accurate prediction as to how far Canadian life expectancy will fall over the coming years. Those outcomes will be very sensitive to the number of COVID bouts suffered by the average Canadian and the cumulative impact of that many bouts on each person’s overall health. Most of us would agree that life expectancy per se is less important to us than our remaining years of reasonable health and independent living. Worsening long COVID symptoms through multiple bouts of illness are anathema to that hope.
Any reasonable person would agree that the best way to avoid long COVID is to entirely avoid infection and, if that proves not to be possible, to absolutely minimize the number of subsequent bouts. For self-serving political reasons, Canadian governments at all levels have largely washed their hands of anything pandemic related, up to and including minimizing to the extent possible the information available to us and muzzling the public health authorities whose mandate it is to help us avoid infection. Until and unless that changes, we are on our own to protect ourselves and our families as best we can. Our most obvious and simple protection is to lay in a supply of well-fitting N95 masks for consistent use in all indoor public spaces. We can avoid in-person public gatherings to the extent possible. Those working in shared office settings could explore pressing our employer to provide a HEPA-grade air filter or, if necessary, to each pitch in to buy one. Those with children in school face more difficult choices but could still explore options with their children’s teachers, school administrators and/or school boards.