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Ottawa's race between the COVID-19 vaccine and the variants

In the past months, the worry over the COVID-19 variants arriving in Ottawa was a question of when, rather than if. This week, we have our answer: It's now. Here's what you need to know now.

This week brought hopeful news about vaccinations, but also worrisome indicators

There have been 10 cases of COVID-19 variants confirmed and another 73 identified as likely in Ottawa so far. In the next few days, the initial screening for the mutation will occur locally, which should speed up the reporting time. (Christophe Archambault/AFP/Getty Images)

It's been a great week for COVID-19 vaccine news in Ottawa.

Health Canada approved a fourth vaccine. The federal government announced more doses than expected of the Pfizer-BioNTech vaccine will be delivered this month. The province laid out an accelerated inoculation plan that pledges anyone can get a dose by the start of summer. The city began vaccinating the 80-and-over crowd, starting with people living in some of the highest-risk communities.

But when it comes to other COVID-19 developments, it's been a worrying week.

Many coronavirus indicators — case counts, hospitalizations, wastewater measurements — are on the rise.  Ottawa is on the edge of more-restrictive red zone, when the city's trying to move to the less-stringent yellow. 

Perhaps most concerning of all is the news that the number of COVID-19 cases involving variants has jumped substantially.

For weeks we've known there were 10 such cases confirmed in Ottawa. But this week, Medical Officer of Health Dr. Vera Etches revealed initial screening had identified an additional 73 cases involving more transmissible versions of the virus.

It's even showing up in the wastewater — a harbinger of possible trouble to come.

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Dr. Vera Etches, Ottawa’s medical officer of health, says the city’s COVID-19 indicators are heading in a direction that could result in a third wave.

Tyson Grabor, associate research scientist and co-lead investigator of the wastewater monitoring program, told CBC Thursday evening that the variant first identified in the U.K. is "now at detectable levels."

Traces remain low and the variants comprise "a minor proportion of active cases," Grabor said, adding things could change "very quickly."

Given this is potentially a huge problem for Ottawa, here's what you need to know about the variant situation right now.

How we test for variants

Viruses mutate all the time, and mutations are common with coronaviruses, according to Ottawa Public Health (OPH).

But the variants that were first identified in the U.K. (B117), South Africa (B1351) and Brazil (P1) are concerning to health officials because they spread more quickly, may make people sicker, or could be somewhat resistant to the current vaccines. 

All three of these identified variants carry the same genetic marker, known as N501Y. When COVID-19 tests come back positive, they are initially screened for the N501Y marker on what's called a spike protein — those little red protrusions you've seen on images of the virus. The results can take a few days. 

If the mutation is detected, health officials assume the case involves one of the variants of concern. But they won't know for sure which variant it is until further testing is completed — a process that can take weeks.

As of this week, the initial screening for the variant is now being completed here in Ottawa, so we should have preliminary results sooner, although the final work to identify the specific variant will still be completed by the provincial labs.

To determine whether a case is a variant, labs test for the N501Y mutation on a spike protein, those red protrusions on the coronavirus. (Alissa Eckert/Dan Higgins/MAM/CDC/Reuters)

Variants indicate troubling trend

As Doug Manuel, a senior scientist with The Ottawa Hospital, put it, the variant is "real and tangible and it will increase transmission."

But what exactly does it mean that Ottawa has 73 probable cases involving variants?

Let's consider the math.

According to OPH data, 1,207 people contracted coronavirus in Ottawa in February, and it's only been since Feb. 3 that all positive test results have been screened for the variant. 

Assuming all 73 cases are confirmed, that means 81 — or just less than seven per cent — of all confirmed February cases were variants. (Two variant cases were identified in January.)

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Doug Manuel, a senior scientist with The Ottawa Hospital, says the vaccine may prevent serious illness and death with some variants of the COVID-19 virus, but it may not have as big an impact on transmission, meaning residents may still get sick.

Considering that modelling predicted that almost half of cases by the end of next week would be variants, seven per cent doesn't seem so bad. 

The problem is that the seven-per-cent figure assumes the variant cases were evenly spread throughout the month of February. If they were concentrated in, say, the last two weeks, the proportion of cases involving variants of concern jumps to more than 16 per cent.

And remember, we have no information yet from the first few days of March, which saw the number of positive cases increase.

Even though we don't have data at our fingertips showing how quickly the variants are spreading, experts say it's almost certain that they are. 

"We can see this happening in other places. It's likely to happen here," said Troy Day, a professor of mathematics and statistics at Queen's University and a member of the province's COVID-19 science advisory table.

Even worse, the situation can be deceptive, at least at first.

As the variants pick up steam in the community, the spread of the original strain decreases. So the total number of cases looks stable, until the variants become the dominant strain.

"And so the worry is that once that happens — as it's likely to do in the next month, unless we do something more strict — the case counts will turn around and start going back up," said Day. 

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Troy Day, a professor at Queen's University and a member of the province's science advisory table, says the fate of the COVID-19 pandemic may hinge on a race between variants of the virus and the speed of the vaccination campaign.

What we can do 

Yes, people are sick of hearing about distancing and masking protocols. Many haven't seen our families and friends for the past year.

And yet, OPH reported an average of 5.5 close contacts for each positive case last week, when it was under three the week before — a sign we are not all following the rules as closely as we should. 

That's why it will come as no surprise what experts say has to happen in order to contain the virus spread.

Tyson Graber is the associate research scientist and co-lead investigator on Ottawa's coronavirus wastewater monitoring program. He says there are low levels of the B117 COVID-19 variant detected in the city's sewage. (Francis Ferland/CBC)

Manuel and others question keeping non-essential businesses open. Places where people congregate, like restaurants, pose some risk. As well, Manuel said, behaviour changes when regions change colours.

"People do not want to hear this," said Manuel. "It's hard to be the bearer of bad news."

Day agrees that "it's a tough call" to shut down society again, but points out that Ontario is following a similar path that the U.K. did before the variant ran rampant there.

"Maybe if we don't do anything now and things magically turn out different here, all will be well," he said. "[But] there's no good reason to expect that that's going to be true."