While national-level COVID-19 data shows a downward trend in daily case numbers, eight provinces have reported patients infected with concerning new variants — the more transmissible strains of the coronavirus.
Infectious disease experts say the B117 strain, originally found in the U.K., and the B1351 strain, originally found in South Africa, are as much as 50 per cent more transmissible. In Ontario, for example, public health officials have said B117 could be the dominant strain in a matter of weeks.
But Dr. Zain Chagla, an infectious disease physician for St. Joseph’s Healthcare in Hamilton, Ont., said there’s reason for hope. He told Dr. Brian Goldman, host of The Doseand White Coat, Black Art, that he’s optimistic because five different vaccines have been submitted to Health Canada for approval, and each may play a role in controlling the variants.
“A year ago I remember having meetings every day in the hospital saying, when is this coming to Canada? How are we going to handle it? You know, seeing those apocalyptic images out of China and Italy, knowing that that was going to be here. And now, a year later, we’re … talking about five vaccines,” said the associate professor of medicine at McMaster University.
“The human spirit is incredible.”
Dr. Zain Chagla, an infectious disease physician for St. Joseph’s Healthcare in Hamilton, Ont., and associate professor of medicine at McMaster University, says he remains optimistic the existing vaccines can fight the COVID-19 variants. (Craig Chivers/CBC)
Health Canada has approved two COVID-19 vaccines, Moderna and Pfizer-BioNTech, and three more may be approved in coming months.
Here’s how the five shots compare, and what we know so far about how they fare in the fight against the more infectious variants.
Pfizer-BioNTech & Moderna
Both Pfizer-BioNTech and Moderna say their vaccines appear to be effective against both the B117 and the B1351 strains, based on blood samples from people who have been vaccinated.
In a statement, Pfizer-BioNTech said these preliminary findings “do not indicate the need for a new vaccine to address the emerging variants.”
Chagla said, thankfully, both of these vaccines seem to be protective against B117 as it’s the variant spreading the most quickly in Canada.
However, as the clinical trials of both Moderna and Pfizer-BioNTech were completed before particular variants of concern took off, more research is needed to gather higher quality data.
A comparison of the efficacy of the five leading COVID-19 vaccines against both the dominant strain of COVID-19 and two key variants, B117 and B1531. (Graphic by Ben Shannon/CBC)
Oxford-AstraZeneca
In the final stages of review, the Oxford-AstraZeneca vaccine is expected to be the next formula approved by Health Canada.
Chagla said the vaccine is about 70 per cent effective against the non-variant strain, based on late stage clinical data released by AstraZeneca.
The news isn’t so great when it comes to the variants. This week South Africa paused part of its rollout of the AstraZeneca vaccine after data from a small trial showed it did not protect against mild to moderate illness from the B1351 variant now dominant in the country.
But Chagla said it’s important to put this news in context, and that more research is needed.
“You still don’t have good news or bad news in terms of if these vaccines still prevent hospitalizations and death,” he said. If it turns out the vaccine does a good job of preventing severe cases “it could still be a useful intervention there.”
On Wednesday, a World Health Organization panel said the vaccine is safe and effective and should be used widely, even in countries where the B1351 variant is dominant.
Johnson & Johnson
Johnson & Johnson submitted its one-shot vaccine for approval in the U.S. last week.
The company says its Phase 3 clinical trial data showed the vaccine is overall 66 per cent effective at preventing moderate to severe COVID-19.
Chagla said there’s a lot of hope with this vaccine, despite the lower overall efficacy rate compared to Moderna and Pfizer-BioNTech’s vaccines which have around 95 per cent efficacy.
He said the fact that it can be kept in a regular fridge and is administered in just one dose means the Johnson & Johnson vaccine could be a game-changer.
“It may not be as efficacious as Pfizer, but perfection is the enemy of good,” Chagla told Goldman.
“If we had the entire Canadian population have a dose of Johnson & Johnson tomorrow, knowing that in 40 days, most people would not be hospitalized or die from COVID-19, I think all of us would breathe a huge sigh of relief.”
WATCH | Why the single-shot logistics of Johnson & Johnson’s vaccine matter:
Calling the clinical trial ‘thorough,’ infectious disease specialist Dr. Matthew Oughton says Johnson & Johnson’s single-shot COVID-19 vaccine is also easier to handle logistically compared to approved vaccines in Canada. 3:40
Novavax
Novavax is a two-dose vaccine that can also be stored at regular fridge temperature.
The company said early findings from U.K. research show its vaccine appeared to be 86 per cent effective against B117 and 60 per cent effective against B1351.
“This is an incredibly important vaccine for both [U.K. and South African] settings and very, very promising for B117, as well as what’s circulating here in Canada normally,” said Chagla.
Canada has signed an agreement for Novavax to produce tens of millions of doses of its COVID-19 vaccine in Canada once it’s approved by Health Canada.
No ‘best’ vaccine
In a few months, Canada may have five different vaccines going into arms, and Chagla said there is no one “best” vaccine among them.
“The best vaccine is the one that’s administered. Every Canadian should be hopeful that they can get one of these vaccines, period.”
Chagla said the next few months are critical. Until enough people have got their shots, Canadians need to hang tight and continue to socially distance, stay home as much as possible, wear masks and follow public health guidelines.
But he’s optimistic better days are coming.
“Hopefully we can talk about a summer and a fall that is getting back to normal.”
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
