As cases of COVID-19 variants grow in Canada, so too does concern from disease experts.
The rapid spread of the P.1 variant in British Columbia has added new urgency to the race between variants and vaccines. In just a matter of days, cases have surged from double to triple digits.
The variant, which was first identified in Brazil, has the potential to lower the effectiveness of some vaccines approved for use in Canada.
Here’s what you need to know:
How is this variant different?
There are thousands of different versions, or variants, of COVID-19 circulating in the world, but only a handful are worthy of true concern — the P.1 variant being one.
The P.1 variant is believed to be more transmissible and capable of evading prior immunogenicity — or reinfect people who have previously been infected with the original, or “wild,” type of COVID-19.
“The thought is that the P.1 variant spent a fair amount of time in an immunocompromised host. During that time it refined itself, it became highly efficient at getting into cells and infecting people,” Dr. Darren Markland, an intensive care physician at the Royal Alexandra Hospital in Edmonton, told Global News Edmonton in a previous interview.
“As a result, it became significantly more harmful because of its ability to rapidly infect a lot of cells in the human body.”
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The variant from Brazil has several key mutations that allow it to behave this way.
One mutation, called E484K, evades antibody response, making it possible for people to be reinfected or for vaccines to be less effective. It also has the N501Y mutation, which helps the virus spread more easily.
Emerging research suggests the P.1 variant is up to 2.5 times more transmissible than the original COVID-19 strain. Another study suggests that out of every 100 COVID-19 survivors, anywhere from 25 to 60 could become reinfected if exposed to the P.1 variant.
As one expert in Alberta tweeted: “It sounds like a brutal new friend to have in the province.”
Problems in B.C.
Cases of the P.1 variant have picked up in British Columbia and Alberta in recent weeks.
B.C. has so far tallied more than 370 cases of the variant — the largest count for any part of Canada — and lab testing is constantly picking up more.
Last week, a large cluster involving the variant was identified in the Vancouver Coastal Health Region, which includes ski-town Whistler, B.C. Smaller outbreaks were later identified in the Fraser Health region and the Interior Health region.
Dr. Bonnie Henry, the provincial health officer, said Thursday that the P.1 variant spread from the Whistler resort municipality “to other parts of the province in very small numbers” and has led to more young people requiring hospitalization.
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The outbreak forced the iconic Whistler Blackcomb ski resort to close Thursday as the province imposed a three-week circuit breaker lockdown in an attempt to curtail the spike in cases being exacerbated by more transmissible variants.
“There’s no focal super spreading event related to these,” Henry said of the Vancouver Coastal Health outbreak, which has since been contained.
“What we’re finding is there are small chains of transmission in multiple areas that aren’t linked, so it is community spread.”
It’s also brushed the NHL.
According to reports, more than half the players on the Vancouver Canucks have tested positive for COVID-19, with several of the cases the P.1 variant. Games have been suspended until at least Tuesday, though it could be much longer as the number of affected players and staff grows.
Questions in Alberta
Alberta is the latest province with P.1 variant concerns.
Over the weekend, the province’s chief medical officer of health, Dr. Deena Hinshaw, tweeted about a “significant” outbreak linked to the P.1 variant. Hinshaw acknowledged the outbreak could be traced to a traveller, but provided no clarity on where the traveller returned from, where the outbreak is located or how many cases are involved.
The outbreak is believed to be the first linked to this variant in Alberta. Its first two cases of the VOC were reported on March 14. As of March 31, there were six P.1 variant cases officially identified in the province.
“I think we’re seeing the trends across the country temporally,” said Dr. Jason Kindrachuk, a virologist at the University of Manitoba.
“They may be differentiated by a week or so between different areas, in regards to how quickly the cases are climbing, but it’s there and it certainly is that they are increasing everywhere.”
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B.C. is leading the way with 379 cases, followed by Ontario with 103 and Alberta with six. Quebec has two cases.
While the bulk of variant cases in Canada involve the B.1.1.7 variant, first identified in the U.K., experts aren’t surprised by how quickly the P.1 variant has spread.
“We’ve known this was coming for weeks and months,” said Markland.
“It means (the ICUs) are going to be very, very busy.”
Markland said his hospital in Edmonton is already seeing an increasing amount of young people requiring COVID-19 treatment. He said many patients require “high levels of support.”
New long-range forecasts for COVID-19 in Canada show overall incidence rates are highest among younger adults aged 20 to 39 and have declined among older Canadians.
Kindrachuk said variants might be impacting younger Canadians more than older ones because so many seniors and vulnerable populations have already been vaccinated.
“We have to appreciate that younger age groups make up a pretty big proportion of our frontline, non-healthcare workers. Those who are still essential,” he said.
“It’s not that surprising we’re seeing the circulation we are in the younger groups.”
Read more:
Alberta Health investigating COVID-19 outbreak linked to traveller with P.1 variant
What do we know about vaccines?
So far, studies suggest that antibodies generated through vaccination with approved vaccines recognize these variants and offer some protection, though it is still being closely investigated.
Dr. Lynora Saxinger, an infectious diseases physician, said lab data suggests the vaccines approved in Canada will offer “some” protection against this variant.
“But we don’t have firm, observed numbers in a community setting,” she said.
Though the variant does not appear to cause more severe illness, it can lower — not eliminate — the effectiveness of vaccines developed by Pfizer-BioNTech and Moderna. However, both shots appear to protect against severe illness.
As for Johnson & Johnson, also approved in Canada, the shot appeared 68 per cent effective in trials in Brazil, where the variant is the most common.
For AstraZeneca, early studies suggest the vaccine will protect against the P.1 variant and that the shot will not need to be modified.
To Markland, that makes sense. He said the AstraZeneca vaccine was trialled later in the course of the pandemic and “had to deal with some of these variants” in its studies more than other shots.
Getting more people vaccinated will “absolutely” help in the fight against the P.1 variant, Markland said, but it’s a “double-edged sword” because it can also cause people to let their guard down too soon.
“Combine that with a little bit of spring fever and you can see people becoming significantly more lax towards preventative healthcare measures,” he said.
“This virus is highly infectious and is spreading exponentially. We are not vaccinating exponentially. So right now, the variants will win this race. And every person who dies of any form of COVID-19 is a preventable death.”
— with files from the Canadian Press, Reuters, and Global News staff
