A Deadly Footrace

If all one looked at were this week’s trends, it would be easy to think we’d turned a corner and were on our way home. For the second straight week, new infections in Toronto fell, as did numbers in Ontario and across North America.

In the city, we averaged about 600 new cases per day – still terribly high but moving in the right direction. Hospitalizations and ICU occupancy were down slightly. And the reproductive number dropped to .8, which should cause numbers to keep falling.

With holiday gathering over, the lockdown and stay at home restriction seem to be working.

Unfortunately, the good news isn’t likely to last long as variants of the coronavirus take hold here.

The rapid spread of the virus worldwide has given it many opportunities to adapt, making itself both more transmissible and less susceptible to attacks from the body’s immune system, whose antibodies are triggered by vaccination or previous exposure. Because these variants spread more easily, they can quickly crowd out existing versions of the virus.

Health experts in both Canada and the United States expect the UK variant, which is at least 50% more transmissible, to be dominant by March. If this happens, it could cause an exponential increase like nothing we’ve seen before. In Great Britain, the variant caused cases to triple in a month. When it got into a Barrie nursing home, it spread to all but two residents, already killing more than 50 of them.

Other variants from South Africa and Brazil, which may not be circulating here yet, may be more concerning because they appear to be both more transmissible and less controllable through vaccination. It’s also possible that any of these variants are more deadly, but that has not been clearly established.

We’re now in a footrace with the virus. Can we slow it down while we vaccinate enough people so that they don’t take hold here? Based on our response thus far, the virus might outrace us.

Here’s how we’re trying to compete:

Vaccines A combination of delays by manufacturers Pfizer and Moderna and a less than optimal provincial rollout means that less than 1% of Ontario’s population has been fully vaccinated. Many residents in long term care have yet to get a first shot and most don’t have the required double dose.

There is not yet a reliable estimate of how soon the general population will be vaccinated; it looks like fall, at the earliest, before everyone who wants the vaccine will have it.

There was also some good vaccine news this week. The mRNA technology used in the Pfizer and Moderna vaccines lends itself to relatively quick modifications to keep us with the variants. And there is talk of a booster dose to increase protection. But that involves a third shot when we are already challenged to distribute two.

The much-anticipated Johnson & Johnson vaccine will likely be approved soon. It requires only one shot and can be stored in a regular refrigerator, but it appears to be less effective than the Pfizer and Moderna vaccines, both of which have a remarkably high 95% efficacy.

Travel Restrictions Today, Canada announced major new restrictions on those flying into the country. All international flights must land in Toronto, Montreal, Vancouver or Calgary.  In addition to receiving a negative test within 72 hours prior to boarding, travellers will be retested on arrival and required to quarantine in a government-approved hotel, at their own expense, until  a negative test result comes back. Those who test positive must continue the hotel quarantine; those testing negative will need to quarantine at home for 14 days.

These restrictions will not be fully in place until mid February. In the meantime, Ontario today announced that, beginning Feb. 1, all international travellers landing at Pearson must either agree to a rapid test or be fined $750. In addition, the Prime Minister announced that all major Canadian airlines have agreed to end flights from sun destinations like the Caribbean and Mexico until April 30.

These restrictions will certainly help, but it’s another case of government response coming later than it should have – at least for the UK variant which is already spreading in the community.

Now is not the time to get careless. You know what you’re supposed to do, and not do.

And since we won’t go anywhere warm this winter, we can join the Mamas & Papas for some California Dreamin’.