How Alberta Gave Measles the Advantage

Thanks to the unending chaos-making of Premier Danielle Smith, southern Albertans woke up last week to discover they now live in a special post-pandemic geography.

Alberta Health Services, an agency that Smith has dismantled because she didn’t approve of its COVID response, declared last week that “all individuals living, working, or attending school in, or travelling to” southern Alberta now live in a zone exploding with the world’s most contagious virus.

And not by happenstance. Smith, a vaccine skeptic and disease contrarian, has worked hard to make her province a burgeoning measles republic.

Silencing the top doctor

When the first cases of the virus appeared in March, she said nothing.

In April chief medical officer of health Dr. Mark Joffe resigned because he wasn’t allowed to speak loudly and say much about the importance of immunization and the containment of a nasty virus in difficult-to-reach rural communities.

After his resignation Joffe pronounced that the measles epidemic represented “a complete failure of leadership at all levels.”

When the cases started to explode exponentially in May, Smith still said nothing. Or not much. At one point the premier repeated the phrase “Don’t get measles. Get vaccinated.”

Did she mean it? Who knows given all the other times she’s signalled distrust of vaccines.

A proven defence

Measles is an ancient virus that modern medicine had largely banished from public concern in Canada. But thanks to the slow and reluctant response of the Smith government, it has become a massive force in Alberta infecting more than 600 people, most of them children. Most of the cases — more than 450 — have occurred in southern Alberta.

You’d never know from Smith’s accounting that measles is a preventable disease. Two doses of the vaccine does the job. The vaccine dates back to the 1960s. It is old technology, and one mostly taken for granted.

But for a variety of reasons, including vaccine hesitancy, conspiracy theories, apathy, religious beliefs, isolation, a profound loss of trust in public health and the arrogance of experts, only 50 per cent of children in southern Alberta have received two doses of the vaccine.

Without a 95 per cent immunization rate, measles can fester away. No health zone in the province currently commands that threshold. Some rural areas have vaccination rates as low as 30 per cent.

Here’s what a real leader concerned about the health of children should have said about measles a couple of months ago.

Most citizens regard measles as a fairly benign spotting disease thanks to the success of the measles vaccine that appeared in the 1960s.

But whenever you remove the vaccine from the modern picture, measles can pack a powerful biological punch with a host of symptoms: cough, runny nose, skin rash, headaches, diarrhea and vomiting. And yes, all that viral discomfort will result in natural immunity for life. But that’s not all.

Uncertain complications can occur in 30 per cent of cases resulting in hospitalizations. The complications aren’t minor. They include wicked ear infections (that can be followed by hearing loss), viral pneumonia, bacterial superinfections and acute swelling of the brain.

The risks of bad outcomes are compounded for children suffering from malnutrition and vitamin A deficiency. An enduring legacy of the COVID pandemic is that many people’s immune systems have been weakened, which also raises risks of a severe and damaging bout of measles.

The harsh equation is that every 1,000 cases of measles typically result in the death or brain damage of two to three children. No parent ever wants to be part of those statistics. But Alberta is racing into that harrowing country.

Potential long-term harm of measles

There are two other facts every parent should know about the character of measles. The first is something called immune amnesia. Unlike other viruses, measles has the unique ability to wipe clean a child’s immune memory of past infections. It essentially resets the immune system to that of a newborn, making the child more vulnerable to any infection, from mumps to influenza, that comes calling.

As one expert put it: “Measles virus is especially dangerous because it has the ability to destroy what’s been earned: immune memory from previous infections.” One 2021 study even found that as measles vaccination rates drop, it will be harder to contain another pandemic because of immune amnesia.

The second key thing is something called subacute sclerosing panencephalitis, or SSPE. This brain-rotting condition can erupt six to eight years after chronic infection in a young child. Somehow the virus remains persistent in the body. It smoulders away and eventually undoes the brain, resulting in personality loss, seizures and death.

Doctors once thought SSPE was pretty rare. But a recent study on measles epidemics in the country of Georgia found the condition wasn’t so uncommon. It appeared in about one in 3,000 cases of infection. Given Smith’s efforts, Alberta could soon have cases of SSPB. That's not a sign of progress. Or good health. Or leadership.

Now here’s another health matter for parents and communities to ponder when considering natural immunity versus vaccinated immunity. Many citizens believe that when it comes to infections, what doesn’t kill us will make us or our children physically stronger. During the pandemic many public health officials actually suggested that COVID infections would be good for children and boost herd immunity. That wasn’t good advice. Or true. And now schools are seeing higher rates of absenteeism from sick kids.

Turns out repeated exposure to infections doesn’t really make children stronger, for reasons experts don’t fully understand. A recent Danish study compared children with low levels of infection versus those with a high burden of infections (16 or more) in early childhood. It found that the sick just got sicker as they got older.

Children who experienced lots of infections early in life “have higher risk of moderate to severe infections and antibiotic use throughout childhood.”

In other words, as immunologist Anthony Leonardi has controversially theorized, frequent infections may predispose people “to severe disease by virtue of aging or dysregulating the immune system.”

More reason for an air quality crusade

Here’s another pertinent thought. Measles is contagious as hell and airborne just like COVID. If you put a child with measles in a crowded room, 90 per cent will walk away with the virus. Just one contagious person can share measles with 12 to 18 fellow Albertans by coughing and sneezing. Moreover, the infected can share away for four days before they come down with fever or the telltale rash.

That means managing air quality in schools, hospitals, homes and churches can reduce transmission. Cleaning up bad indoor air in an age of rapidly emerging diseases is probably the best pandemic preparedness measure a society can invest in.

And there are other benefits besides reduced sickness. Improving indoor air quality through ventilation, filtration and humidity control not only works against other viruses but reduces other forms of pollution such as smoke.

One last point — and we’ll never hear it from Danielle Smith.

Pandemics, just like disruptive technologies, unsettle societies indelibly. We are now living in the political wake of COVID amplified by chaotic technological change. History shows that after pandemics have run their course democracies are harder to govern, extreme beliefs take root with abandon and the ground becomes fertile for demagogues and the power hungry.

Before the pandemic, most people, regardless of their politics, regarded vaccines as a generally positive force for the public health of society. There remained healthy questions about safety, mandates and sheer number of vaccines, but most people accepted the practice. The pandemic changed that reality. Its mask and vaccine wars left a political legacy of animosity and distrust.

Some political parties took advantage of the discord caused by vaccine mandates and championed the anti-vaxers. Neither Alberta nor Canada has yet to hold a post-mortem on learnings from their COVID pandemic responses. Imagine if we attempted to learn from the past and prevent a worse future?

But no. As a result of this avoidance and denial, Alberta now faces a measles epidemic that could become severe in its consequences for children.

Many doctors and health experts may privately lament falling vaccination rates but they don’t want to ruffle any feathers while anti-vaxers control the political conversation in Alberta. At the same time many officials aren’t engaging in real time with real communities about their doubts and concerns for fear of the political fallout.

What this all means is simple. If Alberta can’t marshal a credible response to a measles epidemic, then God help the republic of Alberta in the next pandemic.

Smith has made clear that her ever-changing priorities include cheers for Donald Trump, subservience to resource developers and enabling rhetoric for separatists. The health of the province’s children does not seem to be one of them.