The Omicron variant of the virus that causes COVID-19 was last year’s unpleasant holiday surprise. More than a year later, a loosely knit group of “disease detectives” across Canada continues to keep watch for key mutations.
Officials with the World Health Organization (WHO) say Omicron is better able to pass from person to person than previous versions of the virus.
And so researchers have shifted their attention to Omicron’s offspring.
“Are we ready to take the hit of another wave of a new variant that might emerge? I don’t think so,” Mike Ryan, the WHO emergencies chief, said of China’s latest outbreak at the agency’s last scheduled news conference of the year on Dec. 21.
Researchers look for mutations in the genetic sequence of the virus that might offer a variant a growth advantage over previous versions, cause more severe illness or help it to get around our immune defences.
“Omicron, the latest variant of concern, is the most transmissible variant we have seen so far, including all the subvariants that are in circulation, more than 500 of them. So we will continue to see surges of infection around the world,” said Maria Van Kerkhove, WHO’s technical lead for COVID-19.
It’s critical to continue to monitor known variants, as well as being able to detect new ones, so that strategies can be adjusted if needed, she said.
Like a wolf in sheep’s clothing
To Canadian variant tracker Fiona Brinkman, mutations in genetic sequences of SARS-CoV-2 offer important clues to identify trends and detect new clusters of cases or outbreaks.
“These viral sequences tell a little story about what’s happening right now that give us a hint about what the story will be to come,” said Brinkman, a professor of molecular biology and biochemistry at Simon Fraser University.
“You’re taking this data and then trying to be a detective.”
Travellers are pictured at Vancouver International Airport after a heavy snowfall in British Columbia last week. Canadian doctors and scientists are expecting a bump in COVID-19 cases after the holidays. (Ben Nelms/CBC)
When the virus mutates to something that’s harder for our immune system to recognize, then it’s harder to fight an infection.
“It’s literally like a wolf putting on sheep’s clothing,” Brinkman said.
Brinkman and her team are currently tracking “a whole soup of variants,” in part to predict what might happen so health-care officials can plan staffing amid ongoing shortages, overrun emergency departments and a lack of primary care.
“How big is that impact going to be in January, after the holiday season?” Brinkman asked. “We wouldn’t be surprised if we see a bump in cases.”
On the lookout for major new variant
Elsewhere in the country, Art Poon calls himself a scientist who specializes in tracking viruses — how they evolve and how they spread. His day job focuses on HIV.
Scientists use “molecular bread crumbs” left by the virus to figure out where COVID has moved between countries, he said.
“We would be looking for a rapid increase in the number of infections,” said Poon, an associate professor of virus evolution and bioinformatics at Western University in London, Ont. “Is it spreading faster than we would expect?”
But the decline in testing and sequencing for the virus means we’re “driving blind” in trying to make accurate predictions, said Brinkman.
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Poon, Brinkman and dozens of other trackers across Canada meet weekly, virtually, applying their computational and modelling skills to COVID-19. They also share their sequencing findings with international counterparts.
It’s important to realize that there’s “no big new variant” that we’re seeing right now, Brinkman said.
“That doesn’t mean one won’t occur. One of the important components about this work is to really catch those new variants that are really significant as soon as possible.”
The COVID-19 picture in Canada is increasingly unique in the world, given differences in when Omicron hits and how hard, as well as varying degrees of immunity from vaccinations.
Fiona Brinkman advocates for surveillance of variants in Canada because it’s now harder to apply what’s happened elsewhere in the world to make predictions for here, she says. (CBC)
“Surveillance within Canada is going to become very important,” Brinkman said. She advocates for surveillance here, because it’s now harder to apply what’s happened elsewhere in order to make predictions for Canada.
National data from the federal government’s COVID-19 Immunity Task Force suggests more than 70 per cent of people across the country have been infected. While there was a large jump in infections during Omicron waves in 2022, fewer of those aged 60 and older show protection from antibodies following infection.
Beyond COVID-19, Brinkman hopes to apply the tools scientists have developed during the pandemic to study other troublesome infections, like influenza.
“We are definitely going to be seeing new variants,” Brinkman said. “Whether that’s going to be COVID or whether that’s going to be flu is another story.”
As multiple respiratory infections like COVID-19, influenza and respiratory syncytial virus (RSV) continue to sicken Canadians and further stretch our health-care system and medical staff, Brinkman shared preventative advice backed by public health data.
“One of the best masks you can wear is a recent vaccine shot,” she said.
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.
