Vaccines may be halting outbreaks

New cases in nursing homes are `way down'

The evidence is anecdotal and less-than-definitive, but experts say the limited amount of COVID-19 vaccination completed in Canada is already having a tangible, positive impact.

Outbreaks in long term care facilities have been stopped or prevented in the wake of residents receiving coronavirus shots, say doctors in British Columbia and Ontario.

In hard-hit Toronto, for instance, the number of new nursing home outbreaks is “way down,” and in homes with existing outbreaks, new cases seem to stop at about 21 days after the residents received their first vaccine dose, said Dr. Allison McGeer, one of Canada's leading infectious-disease specialists.

Such results are obviously the hoped-for goal of a vaccination campaign, but the apparent success as Canada's initial supply of vaccine peters out provides at least a glimmer of hope amid the continuing infection and death.

“It certainly looks like the vaccine is doing what it's supposed to be doing,” said McGeer Monday. “It's definitely something to celebrate. If this is happening, it's brilliant.”

The virus hit a secondwave peak in Ontario's nursing homes Jan. 15, when more than 1,600 residents and 1,300 staff had COVID-19. By this past Sunday, the numbers had fallen to fewer than 500 and 700 respectively, a sharper decline than seen in the overall population.

The development is particularly encouraging given that phase three trials of the Pfizer-BioNTech and Moderna shots approved in Canada did not test the drugs in frail elderly people, she said, leaving some doubt about how effective they would be in that population. Immune response and the effectiveness of vaccines tends to lessen with old age.

And reducing illness just in long-term care is no small thing, given that more than 60 per cent of the country's COVID deaths have occurred in the facilities.

But experts caution that until much more of the population is vaccinated, and with a third wave likely coming later in the winter, it would be unwise to let up on pandemic-control measures yet.

Canada had administered about 1.1 million doses of vaccine by Monday afternoon, most going to longterm care residents and staff and other front-line healthcare workers.

For various reasons, deliveries have dwindled and are not expected to pick up markedly until late next month.

In the meantime, though, B.C. has managed to immunize most of its long-term care residents, and the results are showing, says Dr. Steven Chow of the province's medical association.

Vancouver Coastal Health, for instance, had a large number of care homes with substantial outbreaks that started to diminish once the vaccine began rolling out, said the president of Doctors of B.C.

“It basically stops all these outbreaks in their tracks,” said Chow. “Once the population gets vaccinated, boom, it just stops in its tracks. (And) the staff are not getting it, so they're not calling in sick.”

Experts caution that there are other factors that could help explain the improving scene in the nation's coronavirus-ravaged nursing homes.

That includes shrinking infection rates in the overall population and improved infection-control in the facilities themselves.

But they say it is fair to assume that vaccination is already playing at least a part in the trend.

“We're seeing fewer outbreaks and fewer active cases in residents and even fewer active cases in personnel working in longterm care,” said Dr. Isaac Bogoch, a University of Toronto infectious-disease professor.

“Clearly, this is the most vulnerable of the vulnerable in Canada, which is why we prioritized them for vaccination, and now we're reaping the benefits.”

Dr. Gerald Evans, head of the Queen's University medical school's infectious-disease division, agreed, saying that “intuitively it should and will control outbreaks.”

“That's a piece of COVID good news,” echoed Colin Furness, a University of Toronto epidemiologist whose expertise includes pandemic management.

But with the next large batch of vaccine not arriving for another month or more, such effects will not be felt in the general population until the summer, he predicted.

In the meantime, the spread of the more-contagious U.K. B.1.1.7 variant of the SARS-CoV-2 virus is likely to fuel another wave of infection in late March or early April that “will make the last two look like nothing,” said Furness.

“We are going to get whacked.”