Scientists are keeping a close eye on a new variant, BA.2.86, which is as different from today’s predominant strains as the original Omicron was from its predecessor, Delta.Spencer Colby/The Canadian Press
COVID-19 infections are rising again in Canada, just as children return to school and adults prepare for indoor gatherings where respiratory viruses of all kinds spread more easily. Scientists the world over are also keeping a close eye on a new variant, BA.2.86, which is as different from today’s predominant strains as the original Omicron was from its predecessor, Delta.
But experts say Canadians are better off preparing than panicking. The vast majority are safer from COVID today than in the early years of the pandemic, thanks to a combination of vaccine and infection-induced immunity. Here’s what everyone needs to know about COVID and other respiratory viruses as we head into the fall.
The state of COVID now
COVID infections and related hospital admissions are creeping up again, according to the Public Health Agency of Canada (PHAC). The number of hospital beds across the country occupied by COVID patients in the week ending Aug. 29 was 1,836, up from 1,723 the week before. Rates for people in hospital have been climbing slowly since the start of August, after six months of decline.
Fortunately, only 60 of those patients – about 3 per cent – were sick enough to require an intensive-care bed in the most recent week. The virus continues to prey overwhelmingly on the elderly and immunocompromised.
The test positivity rate, a useful barometer of COVID spread, is also rising. PHAC’s most recent epidemiological report put the rate at 11.6 per cent nationally, up from 8.4 per cent as of Aug. 5, and 5.7 per cent as of July 8.
“That is an underestimate of what’s actually circulating in the community,” said Donald Vinh, an infectious-disease physician at the McGill University Health Centre in Montreal, because most people with mild or moderate COVID infections aren’t tested at labs any more. Wastewater testing is also pointing to an increase in infections, Dr. Vinh said.
Sarah Otto, a professor of evolutionary biology at the University of British Columbia, suspects infections are up because our body’s defences are down. “Frankly, many of us have not had a vaccine for a very long time and have not had an infection for a long time,” Dr. Otto said. “So our immunity is really waning at this point and making us susceptible again.”
Watching out for BA.2.86
What’s not behind the modest increase in COVID in Canada is BA.2.86, the new Omicron sublineage that has COVID researchers on high alert. So far only a single case has been identified in Canada, in a patient from British Columbia’s Fraser Health Region who had not travelled recently and wasn’t sick enough to be admitted to hospital.
Scientists are concerned about BA.2.86 because its genetic sequence has more than 35 amino-acid changes from XBB.1.5, the sublineage that predominated until recently. The changes amount to an evolutionary leap that could help it evade immunity from vaccines and past infections. British officials cited BA.2.86 in their decision this week to start the country’s fall COVID and flu vaccination campaigns early on Sept. 11.
Howard Njoo, Canada’s deputy chief public health officer, said officials are “hoping for the best, but preparing for the worst,” when it comes to BA.2.86.
There are reasons for cautious optimism, according to Dr. Otto, who tracks the evolution of SARS-CoV-2 as a leader of CoVaRR-Net, the Coronavirus Variants Rapid Response Network.
BA.2.86, which was first identified in Denmark last month, hasn’t spread like wildfire the way the original Omicron did when it emerged in late 2021, which suggests BA.2.86 may not have a transmission advantage over the predominant variants. As of Monday, just 37 cases from 10 countries have been reported to an international repository for COVID genetic sequences.
“I think we are beginning to get signs that it’s really not spreading as fast as we feared at first,” Dr. Otto said. The next couple of weeks will tell the tale, she added.
A “two-for-one” fall vaccination campaign
Dr. Njoo said the goal for this fall’s vaccination campaign will be to offer flu shots and COVID boosters at the same time wherever possible. “If people come in, they can do a two-for-one. So that’s what we’re obviously pushing for.” Provincial flu-shot efforts usually begin at the end of October, but Dr. Njoo said some jurisdictions are looking at starting their dual campaigns a few weeks early.
Canada’s National Advisory Committee on Immunization (NACI) recommended in June that all age groups for whom COVID boosters are approved should get one this fall if they’ve gone more than six months without a shot or an infection. Health Canada is currently reviewing submissions for new formulations of vaccines targeting the XBB.1.5 variant from three companies: Pfizer, Moderna and Novavax.
Although XBB.1.5 has already been eclipsed by another XBB offshoot, EG.5, Matthew Miller, director of the Michael G. DeGroote Institute for Infectious Disease Research at McMaster University, predicted the reformulated shots will still hold up well against severe disease.
“What we’ve repeatedly seen in studies that have looked at vaccine effectiveness at the population level is that even when there’s a mismatch of the vaccine antigen relative to the virus that’s circulating, time since last vaccination is the most powerful predictor of protection,” Dr. Miller 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.
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