Pedestrians cross at the intersection of Yonge and Dundas, in Toronto, on March 3, 2021.Fred Lum/the Globe and Mail
As Ontario implemented a stay-at-home order Thursday and Quebec announced it will expand some curfews to tackle increasing COVID-19 cases, the Canadian Medical Association said continually changing restrictions across the country have led to confusion and less adherence to rules.
The national advocacy group representing Canada’s doctors says people are frustrated and changing approaches are detrimental to the purpose of staving off the pandemic.
“It’s time to apply what we know and address these new variants with the same aggressiveness they are displaying,” Dr. Ann Collins, the group’s president, said in a news release Thursday.
“Facing the new variants requires a new and co-ordinated approach to regain control.”
To deal with the spread of variants of concern, Ontario declared its third state of emergency since the start of the pandemic.
COVID-19 is caused by a virus called SARS-CoV-2, and as it spread around the world, it mutated into new forms that are more quickly and easily transmitted through small water droplets in the air. Canadian health officials are most worried about variants that can slip past human immune systems because of a different shape in the spiky protein that latches onto our cells. The bigger fear is that future mutations could be vaccine-resistant, which would make it necessary to tweak existing drugs or develop a new “multivalent” vaccine that works against many types, which could take months or years.
Not all variants are considered equal threats: Only those proven to be more contagious or resistant to physical-distancing measures are considered by the World Health Organization to be “variants of concern.” Five of these been found in Canada so far. The WHO refers to them by a sequence of letters and numbers known as Pango nomenclature, but in May of 2021, it also assigned them Greek letters that experts felt would be easier to remember.
ALPHA (B.1.1.7)
- Country of origin: Britain
- Traits: Pfizer-BioNTech and Moderna vaccines are still mostly effective against it, studies suggest, but for full protection, the booster is essential: With only a first dose, the effectiveness is only about 66 per cent.
- Spread in Canada: First detected in Ontario’s Durham Region in December. It is now Canada’s most common variant type. Every province has had at least one case; Ontario, Quebec and the western provinces have had thousands.
BETA (B.1.351)
- Country of origin: South Africa
- Traits: Some vaccines (including Pfizer’s and Oxford-AstraZeneca’s) appear to be less effective but researchers are still trying to learn more and make sure future versions of their drugs can be modified to fight it.
- Spread in Canada: First case recorded in Mississauga in February. All but a few provinces have had at least one case, but nowhere near as many as B.1.1.7.
GAMMA (P.1)
- Country of origin: Brazil
- Traits: Potentially able to reinfect people who’ve recovered from COVID-19.
- Spread in Canada: B.C. has had hundreds of cases, the largest known concentration of P.1 outside Brazil. More outbreaks have been detected in Ontario and the Prairies.
DELTA (B.1.617 AND B.1.617.2)
- Country of origin: India
- Traits: Spreads more easily. Single-dosed people are less protected against it than those with both vaccine doses.
- Spread in Canada: All but a few provinces have recorded cases, but B.C.’s total has been the largest so far.
LAMBDA (C.37)
- Country of origin: Peru
- Traits: Spreads more easily. Health officials had been monitoring it since last August, but the WHO only designated it a variant of concern in June of 2021.
- Spread in Canada: A handful of travel-related cases were first detected in early July.
If I’m sick, how do I know whether I have a variant?
Health officials need to genetically sequence test samples to see whether it’s the regular virus or a variant, and not everyone’s sample will get screened. It’s safe to assume that, whatever the official variant tallies are in your province, the real numbers are higher. But for your purposes, it doesn’t matter whether you contract a variant or not: Act as though you’re highly contagious, and that you have been since before your symptoms appeared (remember, COVID-19 can be spread asymptomatically). Self-isolate for two weeks. If you have the COVID Alert app, use it to report your test result so others who may have been exposed to you will know to take precautions.
Need more answers? Email audience@globeandmail.com
The Progressive Conservative government had loosened some restrictions in lockdown zones last month even as doctors and nurses voiced concerns about increased infections.
A stark change came this week when Premier Doug Ford announced the return to a four-week stay-at-home order.
Dr. Seema Marwaha works as an internal medicine specialist at Unity Health in the Greater Toronto Area and is the editor-in-chief of Healthy Debate.
Along with fatigue from long hours on the front line, Marwaha said she and her colleagues are also fearful.
“This is the first time where I’ve been really scared during the pandemic,” she said.
“What I’m seeing ... is younger people getting sicker in a more unpredictable way, in a way that’s more difficult to trace in much higher numbers.”
When intensive care units are full, everything for health-care professionals changes because doctors have less options to offer patients, Marwaha said.
Ontario’s new public-health orders are necessary, but came too late, she said.
“We are at a breaking point now,” she said. “I’m worried about where’s the peak going to be and will we be able to handle it.”
Ontario reported 3,295 new cases Thursday – the highest since mid-January – and 19 more deaths. The seven-day average for daily cases was 3,093, up from 1,749 two weeks ago.
“The trends we are seeing are very troubling,” said Dr. Barbara Yaffe, the province’s associate medical officer of health.
There were 1,417 people in hospital with COVID-19. Of those, 525 were in intensive care – 100 more than the peak number of intensive care admissions during the pandemic’s second wave.
Elsewhere, Quebec Premier Francois Legault announced an earlier curfew coming Sunday for Montreal and the suburb of Laval as the province tightened restrictions for the second time in three days.
That province reported another spike in cases and hospitalizations linked to COVID-19 on Thursday: 1,609 new infections – the highest daily number since January.
Earlier in the week, the Coalition Avenir Quebec government closed gyms in red zones, including Montreal, and capped the number of people allowed in places of worship at 25.
Schools and non-essential businesses were closed last week in other regions of Quebec hard hit by the more transmissible variants.
As the variants gain hold in some parts of the country, there have been more people under 60 being treated in hospitals, including in intensive care units.
Dr. Theresa Tam, Canada’s chief public health officer, said in her daily statement that ramping up vaccine delivery is cause for optimism that widespread immunity is on the horizon.
But for now, she said, “the vast majority of Canadians remain susceptible to COVID-19.”
Dr. Howard Njoo, national deputy chief public health officer, said surging cases in Ontario, Quebec and western provinces are particularly concerning.
Alberta Premier Jason Kenney issued a warning to United Conservative legislature members that they cannot flout restrictions and expect to remain in caucus. Almost half the party’s 40 backbenchers have openly criticized a return to stricter public-health orders.
Kenney this week again ordered restaurants and bars to stop in-person dining, halted group fitness at gyms and rolled back customer capacity at retail stores.
The B.1.1.7 variant first identified in the United Kingdom is now the dominant strain in Alberta. Dr. Deena Hinshaw, chief medical officer of health, said Thursday people testing positive for COVID-19 can assume they have the more contagious strain.
There were 1,429 new infections in the province.
British Columbia recorded its highest daily case count since the start of the pandemic Thursday, with 1,293 infections and two more deaths.
The province also shifted its screening strategy away from whole-genome sequencing when looking for variants of concern as those strains become more prevalent.
“We assume that anybody who is positive for COVID-19 needs to be treated as if they have one of these highly transmissible viruses,” said provincial health officer Dr. Bonnie Henry.
Njoo said Canada is in a tight race between getting out vaccines and the spread of variants. Vaccinations are just one part of the response, and public-health measures are important, he said.
More than seven million vaccine doses have been administered and the amount arriving in the country is expected to increase each month.
Ontario has issued a new stay-at-home order today to fight an alarming surge in COVID-19 cases fuelled by variants of the virus. Premier Doug Ford says the order will take effect at 12:01 a.m. Thursday morning and last for four weeks.
The Canadian Press
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