Moving at the Speed of Variants

In an acknowledgement of how dangerous this third wave has become, causing Ontario’s Intensive Care Units to overflow with younger COVID patients who are getting sicker faster, the Province this week imposed a new Stay At Home order.

The Government also announced a faster and more urgent vaccination rollout as vaccines become more plentiful. (See vaccination article below).

This week’s daily Toronto case numbers hovered around 1000, triple the number from just a few weeks ago. Today they jumped above 1300, as the number hospitalized in our city increased by 101 and the percentage of positive cases among those tested hitting 10%, an indication that we’re standing in a forest fire.

Even more alarming is the number of COVID patients requiring Intensive Care, which soared well past 500 this week. Because there is a lag between infections and hospitalizations, these numbers will continue to increase for at least a few weeks until the new restrictions tame the exponential increase.

How serious this situation has become – even after four months of vaccinating those most likely to get seriously ill – is well beyond alarming.

As regular readers of this newsletter will know, our current perilous situation should not have snuck up on anyone, least of all the people in charge of Provincial health policy. A third wave, fueled by dangerous variants, was predicted by almost all health experts even as the second wave was declining and then levelling off in February.

For weeks, Toronto hospitals have been sounding the alarm as patients were moved as far away as Kingston.

Then, Sunnybrook set up a field hospital in its Bayview parking lot.

Hospitals were told to stop all non-emergency surgeries.

This week, Medical Officers in Toronto, Peel, and Ottawa shut down schools after the Province didn’t.

Now, Sick Kids – for the first time ever – is accepting adults needing Intensive Care.

Just as we have all had it up to here with this pandemic, we find ourselves at the most dangerous point. This is due to a predictable and somewhat unavoidable rise in variants, combined with an ill-advised and premature loosening of government restrictions.

It has been known since December that the B.1.1.7 variant first identified in the UK is about 50% more transmissible than the original form and would therefore quickly crowd it out. What has more recently become increasingly clear is that it is also far more dangerous, attacking younger previously healthy people and making them twice as likely to become seriously ill. To hear about that firsthand from a physician in charge of critical care, click here.

In the coming weeks, we are likely to hear much more about the P.1 variant, first identified in Brazil. This variant has recently been spreading rapidly in Western Canada, to the point where Canada has far more identified cases than the United States, which has 10 times our population.

P.1 is potentially the most dangerous of the variants of concern, not only spreading more rapidly and making people sicker but appearing to avoid antibodies produced by previous infections or vaccination.  That has certainly been the case in Brazil where it has swept through parts of the country, infecting people who had already contracted the virus in the First Wave.

More information on all of the variants already identified – and others that will emerge as the virus continues to spread and mutate – will happen as we observe them in real-time. What couldn’t be clearer now is that we need to do all things possible to halt their spread.

The ever-changing restrictions are not always easy to keep track of. So think of the Stay At Home order this way: Do not go out more than is necessary to get some personal exercise or to buy food or other necessities; stay 6 feet away from anyone outside your immediate household, especially indoors, and wear a well-fitting mask whenever you can’t; wash your hands.

This pandemic has been particularly hard on people living alone or caught in less than ideal domestic situations. Those who are more fortunate can agree with Huey Lewis.

– John