Can B.C. get out of the 4th wave with targeted instead of broad-based measures?

Well, here we are again. 

"I wanted it to be over too. I didn't want us to be in this position. But we are," said Dr. Bonnie Henry, B.C.'s chief health officer, earlier this week. 

That "position" is one where cases are rising exponentially for a fourth time in this pandemic, with the rolling average doubling about every eight days for the last month.

It's a frustrating place for people in B.C. to be in, just six weeks after the provincial government removed both the mandate on masks and its declaration of a state of emergency — a decision that is increasingly open to criticism. 

"A lot of health experts noted the decision to drop the mask mandate ... could lead exactly to where we are right now," said Green Party Leader Sonia Furstenau. 

There is some good news: based on evidence from other jurisdictions with a delta variant surge after much of the population was vaccinated, it's highly unlikely hospitalizations and deaths will reach the heights of previous waves. 

And while B.C. doesn't share the vaccination status of new cases in a timely manner, data from other jurisdictions shows a massive reduction in risk of severe illness or death for those fully vaccinated. 

The bad news is transmission is once again high enough to cause dozens of people to be hospitalized each week, and puts children and people unable to be vaccinated at a significant risk.  

And how B.C. gets out of this situation is still an open question. 

Local measures and vaccine mandates

Over the past 10 days, in a series of announcements and news conferences, you can see the strategy Dr. Henry is hoping to take. 

It involves putting targeted restrictions in areas with large outbreaks, and will likely involve a host of vaccine and masking requirements in spaces under provincial control where large numbers of people gather. 

"The level of action that we need to take to prevent severe illness and deaths is different in different settings," she said on Thursday, announcing a vaccine mandate for workers in long-term care settings. 

Henry also said an announcement on post-secondary educational institutions is planned for next week. The next day, the federal government announced a vaccine mandate for plane and interprovincial rail travel. 

One can see where all of this is headed. They're measures supported by all the major political parties and based on initial polling, a vast majority of the public. 

But they are preventative measures for the months ahead, not containment measures for the present, and some wonder whether it's happening fast enough. 

"I would like to see this government respond much more proactively to the moment," said Furstenau. 

"Parents and teachers are expressing a significant amount of anxiety right now, understandably. And I think that it's important for the government to respond in a way that says, 'here's all the information we have, here is our plan.'" 

Will Step 4 ever come?

But whether that plan will involve a broad restoration of the mask mandate, or putting back other restrictions that were in place for steps 1 and 2 of the reopening strategy, is unknown.

"We're decoupling hospitalizations, and deaths particularly, from the cases themselves, so we are looking at a more regional or local approach," said Henry at Thursday's news conference.

However, just a minute later, she said "right now … we don't need to take additional measures across the board, for sure, or in specific areas — but we will if we need to." 

Whatever one thinks of Dr. Henry's rhetorical strategy, certain things are clear: the government will need to make a decision on mandatory masks in schools in a matter of weeks. They'll need to decide whether to indefinitely delay Stage 4 of the reopening plan — scheduled for September 7, in which virtually all restrictions are eliminated — or drastically change it. 

And they'll need to decide whether to recentre the pandemic as a daily priority in the government's communication strategy, or hope this wave will pass relatively quickly. 

In the meantime, once again, the public is left to wait and hope.

"I don't understand the approach, quite honestly," said Furstenau. 

"I think that ... what we need is a lot greater transparency. Clear communication. And a recognition of where people are at."