MARCH COVID-19 UPDATE IN BC: EPIDEMIOLOGY, VACCINES AND VARIANTS - PHYLOGENETIC TREE OF SARS-COV-2 VARIANTS BY NEXTSTRAIN.ORG - THE UNIVERSITY OF ...
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March COVID-19 update in BC: epidemiology,
vaccines and variants
1.351 (South Africa)
Phylogenetic tree of
SARS-CoV-2 variants
by nextstrain.org.
P.1 (Brazil) March 30, 2021
B.1.1.7 (UK) Stephen McCarthy, PhD
Presentation outline: 1. COVID-19 epidemiology and new restrictions 2. BC COVID-19 immunization progress 3. COVID-19 variants of concern
1. COVID-19 Cases: Canadian provinces
COVID-19 Cases: Health Authority
COVID-19 Cases: Fraser Health
COVID-19 Cases: Northern Health
Epidemiology: • Over the last month, higher rate of infection in 19-39 years old. • Test positivity up from 6.5% to 9.7%. • We are entering a third wave, after a slow and steady increase in rate of new infections. • Mostly in lower mainland, in particular Fraser South (Surrey). • Concern that more young people are being hospitalized, needing ICU care, and requiring longer hospital stays. • We do not yet have the required vaccine-coverage to slow the pandemic in our province.
What’s causing this new wave? • Five main drivers: People in workplace clusters, or home clusters. Challenge for everyone wanting to be with friends and family, indoor gatherings. Travel within the province. Also skiing in Whistler area, staff housing in Whistler. Increased transmission of variants of concern. Recent March break travel and socializing will add to these. • Data from the UK demonstrates B.1.1.7 causes more severe illness. Thus, as more young people are getting COVID-19, this may explain the higher rate of hospitalization of this age group in March. • B.1.1.7 is much easier to spread in indoor settings. Same means of spread as wild type virus, but lower margin for error when we protecting ourselves. • As indoor gatherings of any size are a risk, that is why an outside group of 10 is permitted. • BC Public Health recommends we continue to delay small indoor gatherings or celebrations until the summer.
Some good news: • There were 42 long-term care outbreaks as of January 15 2021. Now there are only two. • Social visitation at LTC facilities beginning April 1st.: 2 visitors and a child. Facilities will allow physical touch (still have hand washing, wearing masks). • Resuming resident communal dining, small group activities, and resident outings J.
COVID-19: One Year of the Pandemic in BC, March 11, 2021, BCCDC
COVID-19: One Year of the Pandemic in BC, March 11, 2021, BCCDC
Circuit Breaker restrictions:
• Three-weeks long until April 19th, starting today.
• Indoor dinning at restaurants, pubs and bars will be on hold. Patio and takeout allowed.
• Indoor adult group physical fitness suspended. Can still be 1-on-1.
• Indoor faith events also to be suspended. These can still occur outdoors.
• Only essential travel between communities.
• Whistler-Blackcomb ski resort closed.
• MHO in Fraser region: increased Grade 4-12 mask mandates in Surrey schools.
https://www2.gov.bc.ca/gov/content/covid-19/info/restrictions2. Two parallel immunization programs:
• Moderna or Pfizer-BioNTech:
• Age-based risk program.
• Currently inviting 73+ in age.
• AstraZeneca:
• To provide protection for frontline workers.
• Addresses community transmission.
• Fridge stable, providing more flexibility with where we see outbreaks and high-risk
areas/communities.
• Public Health is directly contacting these workers/communities.
• Our province is accelerating vaccination on both fronts. In a few months, both are
expected to converge to offer vaccines to everyone.General update on COVID-19 vaccination: • Three vaccines are available, with Johnson & Johnson coming soon. • Safety monitoring: We continue to see anaphylaxis reactions. No other concerning safety signals in BC. Monitoring of pregnant women and those breastfeeding continues. • AstraZeneca vaccine safety monitoring: clotting remains extremely rare, less than 30 cases in 20 million people vaccinated (0.00015%). The risk of harm from infection far outweighs the small risk of blood clots from vaccination (ex. risk of VTE in COVID-19 + patients, especially if hospitalized). • Nevertheless, the AstraZeneca vaccine is temporarily suspended for those under age 55. Health Canada has requested more data and information from AstraZeneca. • COVISHIELD phase III trial in the US: Efficacy of AstraZeneca vaccine was 79% (two doses). Efficacy higher for preventing severe illness and hospitalization than previously documented.
Vaccine first dose (updated March 29) • 90 + age: 44,068/50,000 immunized (88% acceptance) • 85 - 89 age: 58,900/72,000 immunized (82% acceptance) • 80 - 84 age: 75,247/120,000 immunized (63% acceptance) • Thus far, 286,000 people above the age of 65 have been vaccinated by one dose. • People 73 or older are now invited for appointments (some regional differences), as well as those clinically extremely vulnerable and have received a letter. • Province is ahead in schedule of the age-based campaign. • 12.06% of the total BC population has received one dose in our province (611,803 people).
Vaccination strategy in BC:
Under
Vaccination Vaccinated
British Columbia (BC) COVID-19 Situation Report Week 10: March 7 – March 13, 2021Reduced mortality since vaccine campaign began:
British Columbia (BC) COVID-19 Situation Report Week 10: March 7 – March 13, 2021COVID-19: One Year of the Pandemic in BC, March 11, 2021, BCCDC
BC COVID-19 Immunization progress:
• As of March 29th, 699,092
administered in BC.
• 87,233 are second doses.
• 27,000 doses/day.
• At this constant rate, it would
take until mid-August to
vaccinate the eligible
population of BC (4.3 million,
or 84.8% of the population).
• If uptake is 80% in all age
groups, with vaccines at 90%
efficacy, community (herd)
immunity of 61% can be
reached.Vaccine Second Dose:
• Correlates of protection not yet defined
for COVID-19.
• Current plan is for booster dose 4-6
months after the first dose, for most
people. This will depend on evidence
gathered internationally.
• If cases of COVID-19 increase in those
who have received their first dose, then
BC Public Health will re-examine the time
interval of the second dose.
• Delaying the second dose should help
boost immunity prior to the next fall
respiratory virus season.3. Variants of Concern (updated March 22)
• Province now screening almost 100% of all
COVID-19 + tests for N501Y mutation (1 day)
• Sample then sent for whole genome
sequencing (3-5 days).
• Variants account for 15% of all provincial
cases (1,363 cases total).
• Predominant variant is B.1.1.7 (91%), followed by P.1 (6%), then B.1.351 (3%):
• B.1.1.7 is widespread in the community, but no rapid take-off yet, as in Ontario.
• B.1.351 rate has slowed down. Known clusters of people following public health
advice.
• P.1 rate doubling in last 2 weeks. New Whistler cluster ongoing.Variants of Concern (Cont’d): • The same protective measures to prevent wild type strain transmission, prevent these variants (we know this from management of contacts of variant cases in BC). • Currently no increase in BC hospitalizations or risk of death due to the new variants. • The variants are now beginning to drive transmission, as in the UK and in Ireland. It was a gradual replacement earlier this month, which changed last week. • They are transmitting more easily indoors, leading to the recommendation to spend more time outside for the next 3 months (April - June). • Concerns remain for what these variants mean for reduced vaccine efficacy.
15% COVID-19: One Year of the Pandemic in BC, March 11, 2021, BCCDC
15%
WHO COVID-19 Weekly Epidemiological Update, March 21, 2021.• Model prediction for BC: 800 cases/day by April 1st, 2,000 cases/day by April 30th.
Summary: • Five factors are driving infections in the lower mainland: household socials, workplace exposures, Whistler clusters, recent travel within province, and greater transmission of variants of concern. • The three-week circuit breaker restrictions will likely work, given evidence from other jurisdictions dealing with variants of concern (UK, South Africa). • Between now and May, these next few weeks will be a challenge for us. Expect hospitalizations and ICU admissions to increase. • 1 in 8 people in BC have received their first COVID-19 vaccine dose. Our province is on track to achieve at least 61% community (herd) immunity by this summer. • Expect variants of concern to predominate circulation in the next 1-2 months. • We can encourage each other to gather outside in the same group of 10 people. And to travel to other communities only when it is essential (ex. student electives, work).
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