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Coronavirus variants are testing the limits of what we once thought was safe in Canada

This is an excerpt from Second Opinion, a weekly roundup of health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.


The rapid spread of more contagious coronavirus variants across Canada is driving a devastating third wave in much of the country and increasing the level of risk in situations previously thought to be relatively safe from COVID-19.

Experts say the risk of exposure is higher in everyday situations and the margin of error is lower for what we can and can’t do safely until more Canadians are vaccinated. 

“The things that you’ve gotten away with previously, and that you’ve put into your mindset that were safe … it wasn’t that they were safe, it’s that you got lucky,” said Erin Bromage, a biology professor and immunologist at the University of Massachusetts Dartmouth who studies infectious diseases. 

“That luck — it’s like rolling dice.” 

Bromage said activities such as visiting a loved one, sharing a meal or working out in a gym might seem safe because public health restrictions may allow them, but are even riskier now than they were before. 

The variants of concern not only appear to be more transmissible and potentially more deadly, but Bromage says they may also transmit for longer periods of time in infected individuals and bind to our cells more easily — providing more opportunities for infected people to spread the virus. 

WATCH | Canada facing perilous mix of coronavirus variants:

The mix of COVID-19 variants circulating in Canada has turned the country into a dangerous petri dish unlike anywhere else. 2:07

“If you’re only transmitting for a few days out of an infection cycle, you can only have so many contacts during those days,” he said. “But if that duration of shedding is now twice as long, you can have double the contacts and so therefore it moves more easily between people.”  

Linsey Marr, one of the top aerosol scientists in the world and an expert on the airborne transmission of viruses at Virginia Tech, says it’s possible variants may also be causing more virus particles in the exhaled air of infected individuals for longer.

“The virus is still transmitting the same way,” she said. “What’s different is likely that either the people who are infected are releasing more virus over a longer period of time or it’s possible that it takes fewer of those viruses to make you sick.” 

The number of confirmed variant cases in Canada has skyrocketed in recent weeks, rising from about 2,000 a month ago to close to 17,000 this week and counting, with more than 90 per cent of those being the B117 variant first identified in the United Kingdom.

The P1 variant first discovered in Brazil is also on the rise in Canada, with cases doubling in the past week to more than 1,000 — mostly in British Columbia, Ontario and Alberta. 

And the B1351 variant first found in South Africa is also picking up steam, with more than 150 cases identified in Quebec, more than 70 in Ontario and more than 50 in B.C. as of Thursday. 

“The race between the vaccine and the variants is at a critical point,” Dr. Theresa Tam, Canada’s chief public health officer, told reporters Friday. “It is clear that we need stronger control to combat variants of concern that are driving rapid epidemic growth in many areas of the country.”

Tam said in a statement Thursday that serious illness can occur at any age and evidence indicates that variants of concern can be associated with more severe illness and increased risk of death.

Younger Canadians are being impacted harder in the third wave as well, Tam said, with infection rates highest among those aged 20 to 39 and a rise in the number of hospitalizations and ICU admissions in those under 60. 


Experts say Canada’s third wave of COVID-19 is showing no signs of slowing down, meaning Canadians need to buckle down and take precautions until more of us get a dose of vaccine. (Evan Mitsui/CBC News)

Airborne transmission driving spread

New research is shedding light on the way in which infection was occurring around the world even before variants took hold, calling into question whether our previous public health guidelines go far enough. 

A recent study published by the U.S. Centers for Disease Control and Prevention showed that a singer at a church in Australia in July was able to infect several others from a distance of more than 15 metres indoors. 

While a second CDC study found an infection occurred in a New Zealand quarantine hotel in September after an exposure time of less than a minute in an open doorway. 

And a recent outbreak at a gym in Quebec City where physical distancing and mask use were not enforced has been linked to at least 440 cases of COVID-19 and one death in the community.

Quebec health officials say the rise of variants and a more relaxed approach to public health rules by residents have led to the spike in cases in the province, leading them to introduce a mandatory mask mandate for outdoor activities and indoor workplaces.

“The evidence just keeps piling up in favour of the importance of aerosol transmission,” said Marr. “We thought it was important before, I would say it’s probably predominant in terms of how the virus is transmitted.”

WATCH | Quebec City’s COVID-19 surge leads to more restrictions:

Quebec is imposing more COVID-19 restrictions as case numbers swell, especially in Quebec City where variants have gained control. Quebec City, Levis, Gatineau and Beauce are facing tougher controls while Montreal and Laval are returning to an 8 p.m. curfew. 2:02

Bromage says the reluctance of Canadian public health officials to acknowledge aerosol transmission in a meaningful way has been “frustrating” and adds to confusion among Canadians about how infections are occurring.

Aerosol transmission refers to spread via microscopic airborne particles that can remain suspended in the air longer than larger droplets, which tend to fall to the ground within a distance of two metres — a trait that informed the original physical distancing guidelines. 

“There has been a reluctance to accept that both in schools and in hospitals,” he said of aerosol transmission. “That poor messaging has led people indoors and infection starting up that really shouldn’t have.”

Canada revised its guidelines on how COVID-19 spreads to include the risk of aerosol transmission in November, weeks after other countries and international health organizations acknowledged the airborne threat.

“People tend to latch on to the first thing they hear, which was to wipe down your groceries a year ago,” said Marr. “But I think we need really a campaign to just clarify to people kind of how the virus is transmitting and then policies that match that.” 

The CDC also updated its guidelines to say the risk of COVID-19 infection from surfaces is now officially considered low — meaning disinfecting groceries, wiping down packages and cordoning off playgrounds are likely unnecessary.  

Outdoors not without risk 

Experts say now more than ever, Canadians need to mitigate the increased risk of transmission from variants by going above and beyond public health guidelines and moving activities outdoors — though not all outdoor environments are created equal. 

“Imagine, for example, the terrace of a cafe that would be enclosed by plastic sheeting on three of the four walls, in which you have a lot of people close to one another at tables,” said Dr. Raymond Tellier, an infectious diseases specialist and associate medical professor at McGill University. “This is logically outdoor, but physically has all the characteristics of an indoor environment.”


Now more than ever, experts say, Canadians need to mitigate the increased risk of transmission from variants by going above and beyond public health guidelines and moving activities outdoors — though not all outdoor environments have the same risk level.  (Ben Nelms/CBC)

Dr. Amesh Adalja, an infectious disease physician and a senior scholar at the Johns Hopkins Center for Health Security in Baltimore, Md., says it’s important to remember that while transmission can occur outdoors, it’s much less likely. 

“Even with the more contagious variants, the virus is still going to have difficulty transmitting in those settings,” he said. 

“But when you look at some of the issues that we had in the United States, for example the protests after George Floyd’s death, those were all outdoors and we saw very little transmission.” 

Even if you are moving activities outdoors, experts say to wear a mask with a high filtration level and stay as far apart from others as possible. 

The fact is Canada’s third wave of COVID-19 is showing no signs of slowing down as the vaccine rollout gradually ramps up — meaning Canadians need to buckle down until more of us get a shot, experts say.

Bromage says both Canada and the U.S. have a “rough” couple of months ahead, but that Canada’s slower vaccine rollout means our third wave could last into June. 

“The race is really on in the U.S.,” he said. “The variants are winning in Canada right now, whereas I think in the U.S. it’s sort of neck and neck.”

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CBC | Health News

Canada is losing the race between vaccines and variants as 3rd wave worsens

Much of Canada is in the grips of a worsening third wave as COVID-19 vaccinations slowly ramp up, and experts say the spread of more contagious coronavirus variants is throwing gasoline on an already-raging fire.

“We have a lot of virus moving around the country and escalating very, very quickly,” said Jason Kindrachuk, an assistant professor of viral pathogenesis at the University of Manitoba and Canada Research Chair of emerging viruses.

“Vaccinations are certainly starting to pick up, but we’re nowhere near where we need to be to get this thing under control.”

More than 15,000 cases of the more transmissible and potentially more deadly variants have been reported across Canada to date, with more than 90 per cent of those being the B117 variant first identified in the United Kingdom.

But the P1 variant first discovered in Brazil is also on the rise in Canada, with cases doubling in the past week to close to 1,000 — mostly in British Columbia, Ontario and Alberta. 

And the B1351 variant first found in South Africa is also picking up steam, with over 150 cases identified in Quebec, more than 70 in Ontario and over 50 in B.C as of Tuesday. 

But experts say Canada’s slow vaccine roll out has failed to keep up with the exponential rise in variants in the third wave and the premature loosening of restrictions has led to an increase in hospitalizations and deaths — even in younger Canadians.

WATCH | Variant first found in Brazil newest COVID-19 challenge in B.C.

The P1 COVID-19 variant, first seen in Brazil, is creating a big problem for health officials because of how quickly it spreads. Currently concentrated in the Vancouver area, modelling shows it could spread out of control by late April. 2:06

“People were hoping that we could get to the finish line and get everyone vaccinated without having to deal with another wave and unfortunately that doesn’t seem to be the case,” said Dr. Leyla Asadi, an infectious diseases physician at the University of Alberta in Edmonton. 

“That’s a combination of both our reopening too quickly and now you add in these variants of concern.”

Canada has emerged as one of the only countries in the world with significant outbreaks of three different variants occurring at the same time — turning us into a giant experiment on the world stage.

“There’s no other country that’s kind of dealing with it as we are — we have all of them emerging at once,” said Dr. Zain Chagla, an infectious diseases physician at St. Joseph’s Healthcare Hamilton.

“What happens to all three of them in the mix? Which one takes over? Which one is the fittest of the three?”


Canada has emerged as one of the only countries in the world with significant outbreaks of three different coronavirus variants occurring at the same time and driving a devastating third wave. (Ben Nelms/CBC)

Variants could threaten vaccine effectiveness

Canada’s Chief Public Health Officer Dr. Theresa Tam says another unanswered question that has huge implications for our ability to control the third wave is whether variants like P1 pose a threat to COVID-19 vaccine effectiveness.

“This virus might be capable of evading the immune response,” she said. “But we do not have an actual vaccine effectiveness estimate that is solidified.”

Tam says she has asked medical officers of health across the country to gather more information on vaccine effectiveness against P1 in particular, while encouraging Canadians to get vaccinated and provinces and territories to keep public health restrictions in place.

Amid that black hole of data, Tam says Canada may be able to fill the international research void due to our surging rates of variant cases — for better or worse.

“We don’t have enough information from other countries, including Brazil, about how well these vaccines work against P1,” she said. “If Canada is seeing the evolution of spread of P1, we might be a country where we will be able to produce some of this data.”

Tam says scientists believe one specific mutation common to all three variants, called E484K, could actually allow the virus to escape the immune response and even make it possible for someone who has previously had COVID-19 to become reinfected.


Scientists believe one specific mutation common to all three variants, called E484K, could actually allow the virus to escape the immune response and even make it possible for someone who has previously had COVID-19 to become reinfected. (Evan Mitsui/CBC)

“That was the initial event that caused us to be concerned about this P1,” she said. “There was reinfection in a particular person that already had COVID-19 before.” 

Tam said while there have so far only been laboratory studies done on the antibody response to P1 that showed in some cases there was a reduced ability for a vaccinated person’s antibodies to neutralize P1 — the evidence so far is still a “signal of concern.” 

Officials warn against travelling within Canada

Health officials are imploring Canadians to avoid recreational travel within Canada as the third wave rages, but experts say stricter travel restrictions may not be enough now to prevent widespread outbreaks of more contagious coronavirus variants. 

“Variants of concern are posing new challenges in different locations across the country. Now is not the time to travel for recreational purposes,” Tam said Tuesday. “Limit your travel to essential trips only and do your part to stop the spread.”

Deputy Chief Public Health Officer Dr. Howard Njoo said individuals need to take “personal responsibility to the extent that it’s possible.”

“Stay at home as much as possible, don’t have any sort of non-essential travel — especially vacations going from one province to another.”

Alberta is reinstating strict restrictions at a time when variants are surging, with a total of 676 announced Tuesday making up more than 40 per cent of the province’s active COVID-19 cases.

WATCH | Alberta renews restrictions as communities battle P1 variant outbreaks:

Several Alberta communities fighting P1 variant outbreaks are frustrated by a lack of information from health officials as the province announces a return to tougher restrictions to get its COVID-19 situation under control. 2:09

Officials there are also investigating several major P1 outbreaks at large workplaces, at least one of which is tied to a traveller returning to Alberta from out of province.

“Even before the variants have taken hold, we could have been far more responsive. But we weren’t and now we’re in a situation where we have these variants that are far more transmissible,” said Asadi.

“We have to take far more strict measures than previously, at least for a while until we can get the vaccination rates up.”

Manitoba is the only province or territory outside of Atlantic Canada and the North to implement strict regional travel restrictions, requiring a mandatory 14-day quarantine for all travellers, and has so far avoided a third wave.

“Manitoba implemented it when they saw the variants and the rest of us just didn’t,” said Asadi. 

“There’s just this reluctance to do anything that seems too drastic, whereas doing the same old things results fundamentally in then having to institute stay at home orders, which themselves are really quite drastic but become necessary once you lose control.”


Canada’s Chief Public Health Officer Dr. Theresa Tam says another unanswered question that has huge implications for our ability to control the third wave is whether variants like P1 pose a threat to COVID-19 vaccine effectiveness. (Adrian Wyld/The Canadian Press)

Ontario announced sweeping restrictions and a stay at home order on Wednesday due to a surge in cases and overwhelming pressure on the healthcare system, but stopped short of regional travel restrictions to slow the spread of variants.

Ashleigh Tuite, an infectious disease epidemiologist and assistant professor at the University of Toronto’s Dalla Lana School of Public Health, says variants already make up close to 70 per cent of Ontario’s COVID-19 cases.

“It’s incredibly widespread, so I think there’s merit in restricting movement between areas,” she said. “But as a way to control the spread of variants? That ship has likely already sailed.”

Kindrachuk said Manitoba’s travel restrictions have been a key part of their ability to control the spread of variants in the third wave, but a recent spike in cases and variants locally could jeopardize that. 

“Once they get in, they start circulating a little bit under the radar, and then they start to take off,” he said.

“Now what we’re seeing is really it’s raging in basically all the provinces with the exception of the Atlantic provinces, Manitoba, and the Territories. The question is going to be now, how long can it be maintained?”

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After back-and-forth week, Quebec signals willingness to play by new rules set by COVID variants

Just over one month ago, amid a lull in Quebec’s COVID-19 infection rates, the province’s leading public health official, Dr. Horacio Arruda, used a colourful metaphor to describe the threat posed by more contagious variants of the virus.

“We are right now in a period of calm seas,” he said. “But underneath there are sharks, and those sharks are the variants.”

Despite the warning, the government decided to authorize swimming in these shark-infested waters.

In the ensuing weeks, rules were relaxed across much of the province. The Quebec City area and the Outaouais were among the regions reclassified as orange zones. Restaurant dining rooms and gyms were reopened. There was hope in the air.

Even in Montreal — a perennial trouble spot — extracurricular school activities and large religious gatherings were permitted again. Older high-school students were told to go back to full-time, in-person classes.

But on Tuesday, Premier François Legault played the role of Chief Brody in the movie Jaws. Get out of the water, he told the province.


Quebec Director of Public Health Horacio Arruda responds to a question during Tuesday’s news conference in Montreal. (Paul Chiasson/The Canadian Press)

At a news conference in Montreal, he announced he was cancelling the small freedoms recently granted to residents of the greater Montreal area: gyms will close, extracurriculars will stop, religious services will be capped at 25 people max.

Last week, he announced a series of harsher measures for the Quebec City area and the Outaouais, where cases have grown at exponential rates.

Controlling the variants

Epidemiologists and other health experts had warned the government in March it was making a high-odds bet by lifting measures even though the variants were clearly gaining ground.

The normally staid public health research institute the INSPQ said bluntly on March 26 that the provincial measures in place “were insufficient to control the variants.”

But Arruda, Legault and Health Minister Christian Dubé — le trio, as the francophone press calls them — insisted the moves were justified because hospitalizations were continuing to decrease at the same time as elderly Quebecers were being vaccinated.

In an interview with La Presse last week, Arruda spelled out, with surprising candour, the province’s strategy to a younger journalist.

“If I have 2,000 [new] cases [a day] in Quebec, but we don’t have significant hospitalizations or deaths, we can live with that,” he said.

“Because older people are protected, we will, of course, have people your age who will find themselves in intensive care and die, which is horrible. But is it better if you close everything, and people break the rules in secret?”   

Avoiding Ontario’s fate

At the moment, Quebec is averaging 1,200 cases per day, and so far, hospitalizations haven’t returned to the critical levels seen around Christmas.

Legault said Tuesday he hoped by taking action now, before hospitalizations rise quickly, he can avoid the situation facing Ontario, where intensive care units are hitting capacity and many schools are set to close to in-person learning again.

“It’s a matter of days, or at most, weeks,” he said, before Quebec’s hospital numbers begin to tick upward.

The new measures announced Tuesday, along with those introduced last week, bring more coherence to the government’s message. The added restrictions reflect the danger of a virus that has been turbo-charged by variants.

“It was the right thing to do. We needed to be more proactive,” said Dr. Cécile Tremblay, an infectious disease specialist at the Université de Montréal health centre, following Legault’s announcement.

“The models showed we risked having an exponential growth in cases if we kept the measures as they were before.”

WATCH | Quebec being ‘proactive’ with new measures, says infectious diseases specialist:

Dr. Cécile Tremblay says by tightening measures and offering up AstraZeneca to people 55 and up, the province is trying to keep the third wave under control. 3:10

But the abrupt pivot — from downplaying the dangers of the third wave to re-imposing lockdown measures — has exposed the government to criticism that its public health approach is haphazard. And there are signs its credibility has been damaged.

On the one hand, the government faced protests last week in several Montreal-area schools where students and parents wanted more, not fewer, public health measures in place.

On the other hand, its flip-flop caused whiplash, bitterness and confusion in and around Quebec City. Over the weekend, police there received more than double their usual number of calls about illegal gatherings.

The new rules

Legault wouldn’t admit he had made a mistake by lifting measures last month. “We won’t stop ourselves from providing freedom when we’re able to do so, or closing things again when it’s necessary,” he said.

Throughout the pandemic, the premier has made clear the government’s priority is protecting the health-care network, as opposed to eliminating the virus outright (which was the stated goal of the Atlantic provinces, for example).

Arruda’s comments to La Presse last week only made it apparent what the trade-offs are.

It is a bargain the public has found reasonable to date. Freedom was maximized for the least vulnerable — school-aged children — and progressively reduced for the most vulnerable, especially the elderly.

WATCH | Youth who toil in grocery stores, cafés and restaurants feel the strain:

As the stress of the pandemic wears on, Quebec’s young adults do the essential work that is often overlooked. 3:54

Some in long-term care homes were effectively confined to their rooms for months on end as the virus circulated widely in the community. In turn, they were first up when vaccines became available.

But the more contagious variants of COVID-19 have upended the terms of the bargain. The old methods for containing transmission are no longer enough to prevent the virus from spreading like wildfire, and vaccines can’t be rolled out fast enough to prevent younger people from ending up in hospital.

With the measures announced over the last week, the Legault government signalled it is no longer just talking about these new realities of the pandemic — it has started to adjust to them as well.

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CBC | Health News

Coronavirus variants causing growing alarm in B.C. as cases surge, hospitalizations rise

Experts are growing increasingly concerned about the spread of more transmissible coronavirus variants in B.C. and a consequent spike in serious COVID-19 cases that they fear could overwhelm hospitals in the province.

Doctors say they’re seeing younger patients with the disease — aged 20 to 50 — requiring critical care, in contrast with predominantly elderly people who got badly sick during the first year of the pandemic.

“We do know that a lot of that is the variant[s], and it does seem like it is a more transmissible strain and it also seems that people do get sicker with some of these variants,” said Dr. Gerald Da Roza, head of medicine at Royal Columbian Hospital in New Westminster, B.C.

Da Roza says intake at the intensive care unit (ICU) has increased in the past few weeks at the hospital, where he reported that patients have spilled over into other departments.

“Some people say this is the busiest we’ve been in 15 years,” he said.

WATCH | How the P1 variant is taking hold in B.C.:

The P1 COVID-19 variant, first seen in Brazil, is creating a big problem for health officials because of how quickly it spreads. Currently concentrated in the Vancouver area, modelling shows it could spread out of control by late April. 2:06

The variants of concern in B.C. are B117, first detected in the U.K., and P1, associated with Brazil. Cases of both have so far been concentrated in the Fraser Health and Vancouver Coastal Health authority regions, B.C. Health Minister Adrian Dix said Monday.

He said the number of cases of the P1 variant close to doubled over the Easter weekend.

“The most transmissive variants of COVID-19 are ultimately going to take over,” the minister said.

Dix said 60 of the current 320 coronavirus cases in B.C. hospitals are related to variants of concern. He also confirmed there are pressures on ICUs, especially at Royal Columbian and Lions Gate Hospital in North Vancouver.

‘Worrisome’ spread of P1

B.C. is now being identified by epidemiologists across the world as a notable hotspot for the P1 variant that has spread unchecked through Brazil, where COVID-19 has killed more than 300,000 people.

Dr. Eric Feigl-Ding, a Washington, D.C.-based epidemiologist and health economist, says the accelerating community spread of mutations in B.C. is “worrisome.”

He said that the P1 variant is more than twice as transmissible as the original coronavirus and initial data suggests it causes higher mortality rates and affects younger people more than the initial strand.

Feigl-Ding, a senior fellow at the Federation of American Scientists, raised the alarm a few weeks ago when he compared B.C. to Florida, where variants are also growing in number.

Health Canada reported 379 cases involving variants of concern in B.C. on April 1, up from 84 on March 22. As of Monday, Dix said there are now a total of 588 of the two primary variants in the province: 373 of B117 and 215 of P1.


Staff at Royal Columbian Hospital say the hospital is the busiest it’s been in 15 years. (Ben Nelms/CBC)

Canucks off ice 

The fact that many Vancouver Canucks players have been affected — despite strict NHL safety protocols, testing and the use of personal protective equipment — should serve as an alarm bell, Feigl-Ding said.

“I think this has woken people up because people think … young people are healthy, especially if you’re an athlete. You train well, you shouldn’t have any problems,” he said.

As of Monday evening, a total of 17 Canucks players — most of the team’s active roster — were officially being kept off the ice under the league’s COVID protocols, though that does not necessarily mean all 17 have tested positive for the coronavirus.

Several sources say an unnamed player from the team’s reserve “taxi squad” is quarantining and three members of the coaching staff have tested positive.

While health officials and the NHL have refused to confirm that the team outbreak involves one of the coronavirus variants, hockey insiders at media sources including The Sports Network and The Province have said it is suspected.

One of the players affected, Jayce Hawryluk, contracted COVID-19 last year. 


Da Roza said it’s now a race to get people vaccinated to offset the increased infections he’s seeing in younger British Columbians. 

B.C. is rolling out its vaccine largely based on age, starting with the oldest. As of Tuesday, all residents born in 1950 or earlier are now eligible for their first shot.

Da Roza urges people to be vigilant so that the variants don’t draw out the pandemic any longer.

“Hang in there for a few more months, and be smart about things,” he advised.

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Quebec City, Lévis, Gatineau head back into lockdown as COVID-19 variants spread

Quebec Premier François Legault says Quebec City, Lévis and Gatineau will be essentially shut down for 10 days starting Thursday at 8 p.m. ET to curb the “exponential” rise of COVID-19 cases in these three cities.

Schools will be closed, and students will move to full-time online learning in those three cities.

Gyms, theatres, hairdressers and other non-essential businesses are also shutting down in the three cities, Legault said on Wednesday. Religious gatherings will be limited to 25 people, and there will also be an 8 p.m.– 5 a.m. curfew until at least April 12.

“The situation is critical. It is deteriorating in these three cities,” Legault said. “People have to remain at home unless they absolutely have to go to work.”

With Easter weekend on the way, Legault stressed the importance of staying home and not gathering because COVID-19 variants are on the rise throughout Quebec.

More than half of the cases of COVID-19 recorded in the province will be linked to variants by the beginning of April, according to modelling by Quebec’s public health institute. Public health officials have confirmed that a third wave is underway, and those who are unvaccinated in the 40 to 60 age range are at particularly high risk.

The variant first detected in the United Kingdom is the most prevalent in Quebec. Of the more than 7,400 cases linked to variants in the province, Montreal has the highest concentration, with about 3,000 so far. Quebec City is nearing 1,000 variant infections, and Outaouais is nearing 500.

“The alarm is sounding,” Legault said. “We cannot make any exceptions.”

Hospitalizations have not spiked in these three areas, he added, but they may soon.

“We must act quickly,” Legault said. “Everywhere in Quebec, we have to be more careful.”

Though schools will be closed, daycare services will be made available to those who work in essential services. Parents are expected to keep kids home if they can, and only use these services if they are leaving home to work.

WATCH | Legault explains the new lockdown measures:

Quebec Premier François Legault announced a return to strict restrictions for several cities in the province including Gatineau, which will close non-essential businesses and schools and return to an 8 p.m. curfew. 1:14

Legault is also announcing that four regions are moving from orange to red, in accordance with the province’s colour-coded alert system.

The Outaouais, Chaudière-Appalaches, Lower Saint-Lawrence and the Quebec City region will return to red zones.

Legault said it is time to crack down now and adjust as needed as more data is gathered. Montreal is not affected by the increased restrictions, but that may change as the situation evolves, he said.

Cities see spike in cases

Quebec City, Lévis and Gatineau have been orange zones for more than two weeks, allowing restaurants to welcome diners and gyms to open. But bars remained closed, and indoor gatherings were still prohibited, with guests allowed only under specific circumstances.

With restrictions loosened, cases jumped. In the Quebec City area, 194 more cases were recorded on Wednesday, for a total of 990 active cases there.

“When we go from 50 to 200 cases per day, we are going to have an impact on hospitalizations,” Legault said.

Quebec Health Minister Christian Dubé said there may be 250 cases reported Thursday and that’s why the government can no longer wait. If hospitals fill up with COVID-19 patients, other medical services will have to be delayed, he said.

Dr. Horacio Arruda, the province’s public health director, said the variants are spreading fast, and it is likely because people are ignoring public health rules.

“We have to intervene,” he said.

Travel to 3 cities only for essentials

Arruda said travel to Quebec City, Lévis and Gatineau will not be restricted, but it is “highly recommended” that people avoid these zones because there is such a high rate of transmission. People should only go there for essential reasons, he said.

Earlier in the day, Quebec City’s public health director, Dr. André Dontigny, voiced his concern about the rise in cases and said the current measures weren’t sufficient. A local gym linked to nearly 70 infections was shut down. 

The gym’s management sent out a notice to patrons late last week encouraging anybody who attended the facility since March 14 to get tested as they may have contracted what is suspected to be a COVID-19 variant.

Dubé said the rate at which the disease spread at the gym shows just how extremely contagious COVID-19 variants are when people gather indoors. He said this outbreak should serve as a reminder to those thinking about ignoring public health restrictions and gathering over the holiday weekend or in the weeks to come.

In the Ottawa-Gatineau region, the number of active cases surpassed 2,000 over the weekend as the situation in Ontario worsened.

Legault scaled back public health restrictions in all but the Montreal region on March 8.

Since then, the curfew has been eased — from 8 to 9:30 p.m. — in the Montreal area, gyms were allowed to open and a few other rules were relaxed in the metropolitan area.

Specialist says restrictions should be tightened

Dr. Fatima Kakkar, a pediatric infectious diseases specialist in Montreal, said tightening the restrictions in some of the harder-hit areas in Quebec is going to send an important message to the residents there — showing them that they need to avoid gathering indoors and close contact with others so as to prevent transmission.

“One of the things that has to be clear is that we are not out of the woods, and we are back in dangerous territory,” Kakkar said.

She suspects a false sense of security is spreading through the population as spring approaches, but, she said, people are forgetting that the pandemic is still very real.


Students enter the Pierre Laporte Secondary School in Montreal Monday as all high school grades return to classes full time. Montreal is unaffected by the new lockdown, but in Quebec City, Lévis and Gatineau schools will move to full-time remote learning. (Paul Chiasson/The Canadian Press)

Kakkar supports sending high school students back to school full time and says it is crucial because kids need social interaction for their mental health. 

“As pediatricians, we weigh the risk of infection versus not being in school, and that risk of not being in school has just been so detrimental to so many teens that I think it’s still worthwhile trying to keep kids in school,” Kakkar said.

However, she said, facilities and businesses associated with elective activities, such as gyms and restaurants, should remain closed mainly because of the variants of the disease, which are proving to be more contagious and dangerous.

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Canada’s COVID case count set to hit 1 million next week as variants spread

After two months of relative stability, Canada’s COVID-19 case count is expected to rise rapidly in the coming weeks as virus variants take hold.

Canada is projected to hit roughly 1 million total cases next week, according to data released today by the Public Health Agency of Canada (PHAC).

While the vaccination campaign has ramped up after a period of scarcity, the rollout can’t keep pace with the spread of the virus, said Dr. Theresa Tam, Canada’s chief public health officer. Tam today urged Canadians to reduce their contacts in the medium-term while provinces and territories deploy more shots in the months to come.

“COVID-19 still has a few tricks in store and we need to hold on together a bit stronger and longer until vaccines have us protected,” Tam said.

While the setback is “discouraging,” she said, better days are ahead. “We are closer now than ever, but it’s still too soon to relax measures.”

Asked today when things might return to a pre-pandemic “normal,” Tam said that day is not imminent. With the caseload curve trending up, variants accelerating and vaccine distribution still quite low, a post-COVID-19 Canada is still months away, she said.

“It’s not going to be, ‘Here’s a date and after that date all is going to be good.’ It’s data, not dates,” she said. “By the fall — that’s what I think we should be aiming for.”

WATCH: Tam is asked when life will return to a pre-pandemic normal

Dr. Theresa Tam, Canada’s chief public health officer, responds to a question about the pandemic’s likely end date. 3:37

COVID-19 variants like B117, which is thought to have originated in the U.K., now account for a high proportion of new cases and make up half of all new cases in some areas. There are roughly 3,000 new cases being reported each day nationwide, up from about 2,000 a month ago.

Case count could rise to 12,000 a day

With variants now circulating widely, PHAC said the case count could rise to 12,000 a day if Canadians maintain or increase the number of people they are in contact with daily. The public health measures in place in most jurisdictions will be “insufficient” to keep cases at bay, the agency said.

Alberta, B.C. and Ontario are projected to see the biggest spike in daily cases — early data suggest variants are particularly widespread in these provinces. PHAC predicts Ontario alone could record as many as 10,000 cases a day if public health measures are relaxed or maintained at their current level.

While an increase in the number of new cases is almost certain over the coming weeks in the six provinces west of Atlantic Canada, PHAC says that the country will be able to hold the line at 5,000 cases a day if Canadians reduce their contacts.

PHAC is projecting the death rate will be relatively lower than it was with past caseload spikes because some of the most vulnerable people — long term care home residents, seniors, Indigenous adults — have been vaccinated.

Tam warned, however, that the B117 variant may lead to more severe cases and could prove to be more deadly.

The public health agency said it expects many of the new cases to come from people aged 20 to 39. While death is less likely in this demographic, younger patients still face the prospect of severe health outcomes.

“The younger people, you’re going to get some people who are going to end up in hospital,” Tam said.

PHAC is predicting the cumulative case count — the number of cases reported since this pandemic began — will jump over the next week from 951,000 to between 973,000 and 1,005,000.

The spread of the variants — which are more transmissible than the strain first discovered in Wuhan — has also resulted in an increase in hospitalizations. There are now some 2,200 people in hospitals — 600 of them in intensive care units.

But the vaccination campaign is starting to bear fruit, with case counts among the 80-plus age cohort declining dramatically.

While there were 35 cases per 100,000 people aged 80 or older in January, the case rate has dropped to less than 5 per 100,000.

Most provinces and territories have been directing the early supply of mRNA vaccines like Pfizer and Moderna to seniors. About 60 per cent of all people over the age of 80 have received at least one shot, PHAC said.

The number of outbreaks in long-term care homes is also much lower than it was just three months ago. There were as many as 500 long-term care home outbreaks at any one time in December, while there have been fewer than 100 reported throughout March.

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60% higher risk of death from coronavirus variants, Ontario analysis finds: sources

Variants of the virus behind COVID-19 double the risk of someone being admitted to intensive care — and increase the risk of death by roughly 60 per cent — according to a new analysis of recent Ontario data from the province’s science advisory table, multiple sources tell CBC News.

A briefing note prepared by table members for the province, which is expected to be made public early next week, is based on an analysis of Ontario hospitalization and death data between December and March.

The analysis is expected to show that variants substantially increase the risk of serious illness when compared to the initial strain of SARS-CoV-2, including:

  • 60 per cent increased risk of hospitalization.
  • 100 per cent increased risk of being admitted to an ICU.
  • 60 per cent increased risk of death.

The data didn’t differentiate between variants, though most instances in Ontario right now are thought to be the B117 variant first identified in southeast England.

The Ontario figures were also pooled with data from Denmark and the U.K., two countries hit hard by B117, several sources explained, with local data falling in line with those earlier international findings. 

“Clearly, these variants are … more transmissible — so you’re more likely to become infected if you’re exposed to the virus — and also, you’re more likely to be admitted to hospital and to potentially die from the infection,” said critical care physician Dr. Kali Barrett, a member of the COVID-19 Modelling Collaborative, a separate group that was not involved in the science table’s upcoming briefing note.

Those health impacts are regardless of your age or pre-existing medical issues, she said of the international research.

People need to ‘protect themselves’

CBC News has not obtained a copy of the upcoming briefing note but did speak to multiple sources familiar with the expected contents. They asked not to be named because they’re not authorized to speak about the findings publicly.

Several sources said the analysis accounts for the fact that the age distribution of cases has shifted over time, and now skews younger, thanks in part to ongoing vaccinations of older populations.

It not only aligns with the growing body of international research suggesting variants such as B117 can have dire health impacts, but also the growing concern among Ontario clinicians that patients with COVID-19 are presenting both younger and more seriously ill.

“This is not just a disease that sort of strikes the older among us, it really strikes those in the prime of our lives,” Barrett said. “And we all have to be careful until everyone’s vaccinated.”

The overall risk of death from COVID-19 does remain fairly small, though it’s hard to pin down a precise figure given the evolving nature of the pandemic. 


Ontario residents attend a COVID-19 vaccination clinic in March. (Evan Mitsui/CBC)

Canada’s case fatality rate is currently thought to be roughly 2.4 per cent, but it’s a number based on confirmed cases and deaths among all age groups, which doesn’t reflect people who never got tested for the virus, and has proven to be a moving target depending on who’s falling ill and who’s getting vaccinated.

With variants now making up more than half of all recent COVID-19 cases in Ontario, experts stress it’s a risky numbers game: more people getting infected with a more dangerous variant could cause more serious illnesses and deaths, even among a younger, healthier cohort.

“Unless we have more stringent public health measures enacted,” Barrett said, “individuals really need to be doing everything they can at an individual level to protect themselves.”

Evidence points to higher risk

Health experts around the world have been ringing alarms for weeks about the potential for variants to take hold and wreak havoc.

As early as January, preliminary findings from the British government’s chief scientific adviser suggested B117 carries a higher risk of death than the original SARS-CoV-2 strain.

Two Ontario COVID-19 science advisory table members who spoke on the record to CBC News — though not about the expected briefing note — said the growing body of research that has since emerged suggests those early concerns were valid.

“It’s confounded by a bunch of different factors, including different ages, and different social situations, and how people have acquired the disease,” said Dr. Andrew Morris, an infectious disease specialist with Toronto’s Sinai Health System.

“But I think the majority — or the overwhelming majority — of evidence that we have right now is that it is substantially more, not only contagious, but severe in the disease that it causes.”

Infectious disease specialist Dr. Gerald Evans, a professor at Queen’s University’s faculty of medicine in Kingston, Ont., said without restrictions in place over the past few months, Ontario may have fared far worse in terms of serious cases and deaths. 

Restrictions loosening in various regions

Now, as Ontario is relaxing rules around indoor shopping, dining and other forms of gatherings in various areas, Evans and Morris both said some regions — and younger populations — largely spared in the first two waves of the pandemic could be harder hit the third time around.

“It’s hard for people to continue to just be holed up in their homes,” said Morris. “Perhaps the right thing to do is to just encourage people to spend as much of their time outdoors as possible.”

Indeed, in the Toronto area, for example, public health officials recently got their wish for a loosening of lockdown restrictions that now allow for outdoor dining

WATCH | Ontario allowing outdoor dining in grey zones:

Ontario will allow outdoor dining in grey-lockdown zones after modifying some of its COVID-19 restrictions. Restaurants in the red and orange zones of the province’s colour-coded guidelines will have their indoor dining capacity increased to 50 per cent — up to a maximum of 50 or 100 people, respectively. 2:56

But Morris cautioned that reopenings and reduced restrictions don’t necessarily mean there’s any reduced risk, though that might be the public perception. 

“In no way, shape or form should people be minimizing this pandemic. It still has legs, unfortunately,” Morris said.

“And where you may have had some estimate of risk to yourself six months ago, even three months ago — that estimated risk has now increased a bit.”

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Officials across Canada urge new vigilance as COVID variants spread

The latest:

Alberta’s top doctor is urging people to follow both the “detail and the spirit” of public health measures as the province deals with community spread of a variant of concern first reported in the U.K.

With 1,078 reported cases of the B117 variant reported on a federal tracking site as of Wednesday evening, Alberta trails only one other province — Ontario — in total reported cases of the more transmissible variant.

“The B117 variant is spreading in many different contexts and many different settings,” Dr. Deena Hinshaw said at a briefing on Wednesday. “And we’re seeing higher attack rates than we typically do in settings where people are exposed.”

Hinshaw said that so far, the cases the province has seen of the P1 variant (linked to Brazil) and the B1351 variant (first reported in South Africa) have been few in number and linked to travel.

The B117 variant, however, has been established in the community.

“While we are continuing to work hard to slow its spread, it is spreading in all zones of our province.”


Hinshaw said that while vaccination efforts are ramping up, the province is not yet at a point where the vaccination coverage is sufficient to “prevent severe outcomes.”

“For the next couple of months, including spring break, we need to just hold on and protect our communities with our choices.”

Hinshaw highlighted some progress around vaccinations, pointing to the province’s plan to offer first doses to all adults who want one by the end of June.

Alberta is not the only province concerned about the spread of variants of concern. As of Wednesday evening, the Public Health Agency of Canada had reported more than 4,200 cases of the variants, including:

  • 3,946 of the B117 variant.
  • 240 of the B1351 variant.
  • 71 of the P1 variant.

Ontario has seen the highest total number of cases of variants of concern of any province, with 1,134 cases of the B117 variant, 47 of the B1351 variant and 34 of the P1 variant.

In Saskatchewan, there’s growing worry about variants of concern in Regina, which has seen more than 80 per cent of the province’s variant cases.

Chief Public Health Officer Dr. Theresa Tam said on Twitter that with the increase of variant cases, “maintaining public health measures and individual precautions is crucial to reducing infection rates and avoiding a rapid reacceleration of the epidemic and its severe outcomes.”

-From CBC News and The Canadian Press, last updated at 7 a.m. ET


What’s happening across Canada

WATCH | Inside the race to get COVID-19 vaccines to Canadians:

CBC’s David Cochrane goes inside the processes of vaccine delivery and distribution as well as the challenges to deliver on the promise of at least one shot for every Canadian who wants it by July 1. 4:08

As of early Thursday morning, Canada had reported 919,244 cases of COVID-19, with 31,600 cases considered active. A CBC News tally of deaths stood at 22,554.

In Atlantic Canada, there were three cases of COVID-19 reported on Wednesday — two in Nova Scotia and one in New Brunswick. There were no new cases reported in Prince Edward Island or Newfoundland and Labrador.

In Quebec, health officials reported 703 new cases of COVID-19 on Wednesday and 13 more deaths attributed to the novel coronavirus. Health officials also reported a rise in the number intensive care patients, up 16 compared with the prior day, for a total of 107. Total hospitalizations dropped by one, to 532.

Health officials in Ontario reported 1,508 new cases of COVID-19 and 14 additional deaths on Wednesday. A provincial dashboard listed the number of COVID-19 hospitalizations as 741, with 300 of those patients in the province’s intensive care units.

The top doctors in Ontario’s two main COVID-19 hot spots are preparing for warmer weather. Dr. Eileen de Villa and Dr. Lawrence Loh said they’re seeking to ease some of the restrictions on outdoor activities in Toronto and Peel.

Both medical officers want to keep their communities in the strictest “grey-lockdown” category of Ontario’s colour-coded pandemic framework, but with adjustments that would allow for outdoor dining and fitness.

In the Prairie provinces, Manitoba reported 96 new cases of COVID-19 on Wednesday and no additional deaths.

The Manitoba government also moved to reduce the minimum age for COVID-19 vaccines by two years — to 53 and up for First Nations people, and 73 and up for others. Those numbers do not include younger age groups with underlying health conditions that are already eligible for vaccination.

In Saskatchewan, health officials reported 87 new cases and one additional death on Wednesday. The Saskatchewan Health Authority urged people to be vigilant in the face of variant of concern cases, particularly in the Regina area.

Across the North, Nunavut will now count 12 additional cases of COVID-19, including three deaths, in the territory’s total case count. The new numbers come from Nunavut residents who caught COVID-19 or died from the virus while in Manitoba.

Nunavut Chief Public Health Officer Dr. Michael Patterson said it’s been unclear since the start of the pandemic which jurisdiction these numbers would fall under. The cases and deaths occurred between December 2020 and January 2021. Patterson said attribution of cases of COVID-19 acquired outside the territory will continue to occur on a case-by-case basis.

There were no new cases reported in Yukon or the Northwest Territories on Wednesday.

In British Columbia, health officials reported 498 new cases of COVID-19 and four additional deaths. A joint statement from Provincial Health Officer Dr. Bonnie Henry and Health Minister Adrian Dix said no data about variant cases was available Wednesday due to a lab sequencing issue.

-From The Canadian Press and CBC News, last updated at 7:05 a.m. ET


What’s happening around the world

As of early Thursday morning, more than 121.2 million cases of COVID-19 had been reported worldwide, according to a tracking tool maintained by Johns Hopkins University. The global death toll stood at more than 2.6 million.

In Africa, the head of the Africa Centers for Disease Control and Prevention says the suspension of the AstraZeneca COVID-19 vaccine in some European Union nations hurts efforts to build public confidence and trust in vaccines on the continent of 1.3 billion people.

John Nkengasong said in a briefing Thursday that despite “unfortunate events” in Europe, African nations should continue rolling out the AstraZeneca vaccine, the only shot currently available in many countries that have accessed batches of it through the COVAX initiative.


A nurse prepares a dose of the AstraZeneca-Oxford COVID-19 vaccine at Mulago referral hospital in Kampala, on the first day of a vaccination campaign last week. (Badru Katumba/AFP/Getty Images)

Nkengasong said a recent meeting convened by his group concluded that vaccine-related decisions in Africa should not be “based on anything that is subjective.” He said instead there should be continuous monitoring and reporting of any adverse events following inoculations.

At least 22 of Africa’s 54 nations have received more than 14 million doses of the AstraZeneca vaccine as of March 13, according to the World Health Organization.

The European Medicines Agency, which is expected to update its findings later Thursday, has said there is “no indication” the AstraZeneca shot is responsible for dangerous blood clots in a few recipients. The World Health Organization has also said the benefits of the vaccine outweigh any risks and recommends its continued use. Other European nations are proceeding with vaccinations despite safety worries in countries such as Germany.

In Europe, Italy inaugurated a living monument to its COVID-19 dead Thursday as it marked the anniversary of one of the most haunting moments of the pandemic: when Bergamo’s death toll reached such heights that an army convoy had to transport coffins out because its cemeteries and crematoriums were full.

Premier Mario Draghi visited the northern city on Thursday to commemorate a national day of mourning for Italy’s coronavirus victims. Flags flew at half-mast around the country and public authorities observed a minute of silence.

Draghi laid a wreath at Bergamo’s cemetery and inaugurated a forest named in honour of the more than 100,000 victims in Italy, the first country in the West to be hit by the outbreak.

“This wood doesn’t only contain only the memory of the many victims,” Draghi said. “This place is a symbol of the pain of an entire nation.”

The anniversary came as much of Italy including Bergamo is under new lockdown, with schools and restaurants shuttered, amid a new surge of infections. And it comes as Italy’s halting vaccination campaign has slowed down further because of the suspension of AstraZeneca shots pending review.


A health-care worker prepares a dose of the Pfizer-BioNTech COVID-19 vaccine during home visits to carry out vaccinations in Rome on Wednesday. (Yara Nardi/Reuters)

France is set to announce new coronavirus restrictions on Thursday, including a potential lockdown in the Paris region and in the north of the country, as the number of COVID-19 patients in intensive care units spikes.

“We will make the decisions we need to make,” French President Emmanuel Macron said on Wednesday while visiting the hospital of Poissy and Saint-Germain-en-Laye, west of Paris. He said measures will be “pragmatic, proportionated and targeted.”

Prime Minister Jean Castex is scheduled to detail new restrictions on Thursday. The virus is rapidly spreading in the Paris region, where the rate of infection has reached over 420 per 100,000 inhabitants and ICUs are closed to saturation. France’s nationwide infection rate is about 250 per 100,000.

In the Asia-Pacific region, Pakistani authorities are warning that strict lockdown measures may need to be implemented if the public continues to violate physical-distancing measures to curb the spread of the coronavirus.

Health authorities say a potential lockdown could include closing businesses and restrictions on economic and social activities. The warning was issued Thursday by the National Command and Control Center, which oversees Pakistan’s response to COVID-19.

Amid a third wave of the coronavirus that is gripping Pakistan’s largest province, Punjab, and the northern part of the country, Pakistani health and administrative authorities have imposed a partial lockdown in affected areas since last week. Pakistan has reported 615,810 virus cases among 13,717 deaths.

Thailand will procure an additional 100,000 doses of China’s Sinovac vaccine to be used and paid for by businesses, in the first phase of a private sector vaccination scheme.

In the Americas, Paraguayan opposition lawmakers lost a bid to impeach President Mario Abdo over the government’s handling of the pandemic.

The United States is investing $ 12.25 billion on ramping up COVID-19 testing to help schools reopen safely and promote testing equity among high-risk and under-served populations.

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Do we know how effective vaccines are against the variants? Your COVID-19 questions answered

We’re answering your questions about the pandemic. Send yours to COVID@cbc.ca, and we’ll answer as many as we can. We publish a selection of answers online and also put some questions to the experts during The National and on CBC News Network. So far, we’ve received more than 67,000 emails from all corners of the country.


Are the vaccines effective against all the variants of concern?

Both Pfizer-BioNTech and Moderna say their COVID-19 vaccines appear to be effective against two variants of concern first identified in the U.K. and South Africa, based on blood samples from people who have been vaccinated. But more research is needed on the pair of vaccines, while other vaccine candidates already have some real-world data on their effectiveness against the variants. 

The good news is the coronavirus that causes COVID-19 doesn’t seem to mutate as much or as quickly as the influenza virus that causes the flu. Even with the current, more transmissible variants of concern, people who’ve been vaccinated are not falling severely ill or dying from COVID-19 in large numbers.

But to prepare in case that starts to happen, drugmakers are already re-working their vaccines.

Phil Dormitzer, one of Pfizer’s top viral vaccine scientists, said last week that his company has already made a template for a prototype vaccine targeting the variant first identified in South Africa.


The re-tooling work took on new urgency after South Africa paused its rollout of the AstraZeneca vaccine after data from a small trial suggested the vaccine did not protect against mild to moderate illness from the B1351 variant now dominant in the country.

Despite that, Dr. Zain Chagla, an infectious disease physician at St. Joseph’s Healthcare in Hamilton, Ont., told Dr. Brian Goldman of CBC’s The Dose that he remains optimistic the existing vaccines can fight the coronavirus variants. That’s because five different vaccines have been submitted to Health Canada for approval, Chagla said, and each may play a role in controlling the variants.

“The best vaccine is the one that’s administered,” Chagla said. “Every Canadian should be hopeful that they can get one of these vaccines, period.”

The clinical trials of both Moderna and Pfizer-BioNTech were completed before the variants of concern took off worldwide.

Dr. Noni MacDonald, a pediatrics professor at Dalhousie University in Halfax and a vaccine safety researcher, said as experts gain a more detailed and sophisticated perspective on how the COVID-19 vaccines work, they’ll also gain a better understanding of what types of protection they offer.

Studies suggest the AstraZeneca vaccine isn’t highly effective against the variant first identified in South Africa. Do we know how effective other vaccines are against it?

Yes, we do have some information about the other vaccines.

So far, three drugmakers — Johnson & Johnson, Oxford-AstraZeneca and Novavax — have data comparing how well their vaccines work against the B1351 variant first identified in South Africa.

The variant has a mutation that changes the shape of the viral spike protein.

As a result, lab experiments suggest the antibodies that our body produces have a harder time attaching to the spike protein, reducing the effectiveness of the vaccines, virologists say.

But infectious disease experts say the vaccines could still save lives amid B1351 cases by preventing admissions to intensive care from serious COVID-19, which reduces strain on our health-care systems — the goal of flattening the curve.

WATCH | Re-tooling vaccines to keep up with coronavirus variants:

New coronavirus variants won’t necessarily mean new vaccines or vaccine boosters are needed. And if adjustments are needed, they would take less time to develop than the original vaccines. 2:01

Preliminary data from Johnson & Johnson’s single-dose vaccine suggested it was 72 per cent effective against moderate to severe COVID-19 in the U.S. compared with 57 per cent effective in South Africa, where a more contagious variant was circulating at the time of the research.

The Novavax vaccine also showed some protection against the B1351 variant, said Dr. Isaac Bogoch, an infectious diseases physician with Toronto’s University Health Network. 

In a news release, Novavax said the efficacy of its vaccine in studies from the U.K. was 89 per cent compared to 60 per cent in South Africa. 

Protection can refer to not getting the infection as well as protection against severe infection, hospitalization and death.

“So, while it isn’t perfect, while it isn’t the same, Johnson & Johnson, Novavax and very likely Pfizer and Moderna still provide some element of protection against that variant of concern,” said Bogoch, who is also a member of Ontario’s COVID-19 vaccine distribution task force.

We’re hearing the variant first identified in the U.K. can be more deadly. Is this across all age groups?

“Based on the limited evidence we have, it does seem to be across all age groups,” Maria Sundaram, an infectious diseases epidemiologist based in Toronto, told CBC News Network.

In January, British Prime Minister Boris Johnson said two studies presented to his government suggested the B117 variant “may be associated with a higher degree of mortality.”

Patrick Vallance, Johnson’s chief scientific adviser, said the previous average death rate of 60-year-olds in the U.K. from COVID-19 was about 10 per 1,000. With the new variant, roughly 13 or 14 per 1,000 infected people might be expected to die.

The relative increase in the case fatality rate “appears to be apparent across age groups,” the researchers wrote. “The absolute risk of death per infection remains low.”

Do you anticipate we’ll need booster shots to protect against variants even after we’ve received both doses of a vaccine?

The answer is yes, said Bogoch.

For the first-generation of COVID-19 vaccines, Bogoch said he expects people will eventually need a booster dose.

“Down the line, and I am not sure how much farther down the line, we’d likely need a booster dose with a vaccine or an updated vaccine that accounts for the new variants of concern that are emerging,” he said.


A health-care worker is seen at a COVID-19 testing centre at Ridge Meadows Hospital in Maple Ridge, B.C., earlier this month after a case of a coronavirus variant was detected at a nearby secondary school. (Ben Nelms/CBC)

MacDonald said major regulators such as Health Canada, the U.S. Food and Drug Administration and their counterparts in the U.K. and Europe are meeting virtually to discuss how to evaluate the effectiveness of vaccines against variants.

She said the regulators may ask drugmakers for what are called non-inferiority studies.

Unlike clinical trials to evaluate the efficacy of a vaccine that involve 40,000 to 50,000 people, MacDonald said non-inferiority trials need 400 to 500 people and can be done relatively quickly.

“We’ll do non-inferiority,” MacDonald said. “That is a simpler, easier process and it’s just saying, ‘Are you good if not better than what you had before?'”

Alyson Kelvin, a virologist working on COVID-19 vaccine candidates at VIDO-InterVac in Saskatoon, said surveillance in Canada and around the world will be important to see what variants people are commonly being infected with, both in vaccinated and unvaccinated populations.

“I am optimistic that we’ll still have effective vaccines and we won’t get into as frequently a cycle of vaccination and changing the vaccine formulations as we do with influenza,” Kelvin said.


A lab technician works on blood samples taken from people taking part in a Johnson & Johnson COVID-19 vaccine study in Groblersdal, South Africa, northeast of Johannesburg, on Feb. 11. The five different vaccines submitted to Health Canada for approval may each play a role in controlling the variants. (Jerome Delay/Associated Press)

When someone is infected with the original version of the virus and they develop antibodies, those antibodies have been shown to be less effective against some new variants of concern with altered spike proteins.

Researchers have documented cases of reinfection with the variant first identified in Manaus, Brazil. But reinfections are difficult to prove since doctors need genetic proof showing a distinct coronavirus strain caused each instance of infection. 

Our bodies generate antibodies to fight off a natural infection. Besides antibody-based immunity, our immune system also has T-cell immunity, or cell-based immunity. T cells are a type of white blood cell. 

Kelvin said cell-based immunity is often broader than what we get from just antibodies.

Immunologists say antibodies are also relatively short-lived compared with some T cells

Kelvin said it will be important for researchers to watch for any breakthrough infections from a variant that suggest both arms of immunity are no longer effective.


Alyson Kelvin, who is working on different coronavirus vaccine candidates, is seen in her lab at VIDO-InterVac in Saskatoon, last March. She says she’s optimistic we will still have effective vaccines against the variants. (Liam Richards/The Canadian Press)

Brian Lichty of the McMaster Immunology Research Centre in Hamilton, who is also working on COVID-19 vaccine candidates, said genes for the variants can be swapped into an existing mRNA vaccine, such as those made by Pfizer-BioNTech and Moderna.

“Technically, it’s really simple,” Lichty said. “I can, with my laptop, design a new vaccine in 20 minutes sitting on my couch.”

Then, in the lab, the new gene is synthesized. Finally, the new vaccine is mass manufactured — the step that takes the most time, he said.

Looking ahead, drugmaker GlaxoSmithKline (GSK) said it will work with the German pharmaceutical company Curevac to develop an mRNA vaccine against the variants.

The advantage of existing mRNA vaccines from Pfizer-BioNtech and Moderna compared with vaccines based on older technologies is they don’t need cells or tissue culture to grow. That’s one reason why it is easier to change recipes in their manufacturing lines to address the variants, MacDonald said.

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Lessons learned about coronavirus response, but variants present new concern: WHO expert

A number of lessons have already been gleaned about the international and scientific response to the novel coronavirus, but understanding emerging variants remains a murky area, the expert who led the recent World Health Organization (WHO) mission to China says.

“We clearly have to invest much more in understanding how these viruses are emerging,” Peter Ben Embarek said in an interview on Rosemary Barton Live.

“We also have to improve our surveillance of these emerging diseases so people [identify them] before they jump into humans. And when they emerge like last year, we shouldn’t wait too long before starting to look at the origin of these viruses.”

Those investigations should be happening in tandem with initial responses such as identifying treatment options and positive cases, Ben Embarek told CBC Chief Political Correspondent Rosemary Barton.

The scientist is a food safety and animal diseases expert who was part of a team investigating the origins of the virus in Wuhan, China, where the first cases of COVID-19 were discovered.


Peter Ben Embarek, a member of the World Health Organization (WHO) team tasked with investigating the origins of the novel coronavirus, holds a chart during the WHO-China joint study news conference at a hotel in Wuhan, China, on Feb. 9. (Aly Song/Reuters)

The four-week mission concluded earlier this month, with initial findings suggesting that the virus was introduced to humans through an “intermediary host species.”

There are also indications that there was no widespread transmission of the novel coronavirus before December 2019, though there is evidence there was “much wider transmission” during the second half of that month than previously thought, Ben Embarek said.

What’s the strategy for variants?

But one question that remains unanswered involves new, more transmissible variants of the coronavirus — and whether the world has done enough to control them.

“I think we are dealing with them with a lot of concern and attention, and we are increasingly able to detect them,” Ben Embarek said.

“The big question is, are we good enough at handling them, or are we handling them [as we did] the first one — the original one — and taking the same strategy to control them?”

Ben Embarek said more conversations are needed about those strategies to see whether the measures put in place to curb the spread of COVID-19 can also be applied to emerging variants.

“I think it’s a big question, and nobody has the answers, unfortunately,” he said.

The scientist said he hoped the report’s findings would be taken seriously, despite criticisms of WHO’s praise of China’s early handling of the outbreak.

“It’s also important for people to understand what this mission was and what it was not. It was not an investigation into any wrongdoing or … how the system in China operated from the start of this event,” Ben Embarek said.

“This was a joint study between Chinese counterparts and international counterparts trying to develop and conduct studies that would help us get a better understanding of what happened. And that’s what we did.”

The WHO is expected to present its preliminary report from the mission in the coming week.

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