COVID-19 variant on cusp of community spread, doc says
Simcoe Muskoka’s top public health official warned Tuesday that travel within Ontario should be restricted and school reopenings could falter if community transmission of extra-contagious COVID-19 viral variants takes hold — a reality that may be already be underway after a rash of new positive results.
Samples collected from 99 more people in the region screened positive for a “variant of concern,” the health unit said Tuesday. Two of those cases have no known links to the devastating outbreak at Barrie’s Roberta Place nursing home, where the presence of the U.K. variant was confirmed Saturday in six swabs.
Since then, a total of three cases in Simcoe Muskoka with no links to Roberta Place have tested positive for variants — two of which are involved in separate outbreaks, one at a different nursing home and one at a psychiatric hospital. Full genome sequencing will confirm the variant involved, but the health unit said it expects all to be more instances of the U.K. variant, known scientifically as B.1.1.7, which researchers have calculated is about 50 per cent more transmissible than pre-existing viral strains.
“If it isn’t spreading readily in our community now, it may very well do so in the near future,” Dr. Charles Gardner, Simcoe Muskoka’s medical officer of health, said in a Tuesday press briefing.
Infectious disease specialist Dr. Isaac Bogoch was more blunt: “The horse is out of the barn. We already have community transmission.
“It just means we have to double down on our efforts to keep this virus under control, and vaccinate as swiftly as possible,” said Bogoch, a member of the province’s vaccine task force.
The 99 new cases were identified through a point-prevalence study being conducted by Public Health Ontario, which is analyzing all positive COVID-19 test results from Jan. 20 for the three known variants of concern, a single-day snapshot that will help establish a baseline for how the variants have spread.
As of Tuesday, 47 cases of B.1.1.7 have been confirmed in Ontario through full genome sequencing, according to data from Public Health Ontario — a count that doesn’t include preliminary screening results, including the 99 from Simcoe Muskoka, for which full sequences are not yet available. Variants of concern from Brazil and South Africa have not yet been reported in the province.
Gardner also said Tuesday that 42 household contacts of people linked to Roberta Place have tested positive for COVID-19, in addition to 127 residents, 82 staff, and six essential caregivers and “external partners.” Forty-six deaths have been reported at the home. Recent evidence from the U.K. suggests that besides being more transmissible, the B.1.1.7 variant may be somewhat more lethal, although that finding is debated by experts.
While the outbreak at the home itself may be receding, “the bigger picture … is transmission in the households of staff, and out into the community,” Gardner said. “And to me, we’re at the beginning of that. We’ve got to do all we can to slow that down.”
Another case of B.1.1.7 was identified in the Kingston region in a person who had travelled to Simcoe Muskoka but had not travelled outside the country, according to a health unit spokesperson. The person tested positive for COVID-19 “several weeks ago” but was only identified as a B.1.1.7 case on Monday.
Gardner and Bogoch both said provincial policies focused on international travellers — whether in the form of which cases get prioritized for variant screening, or in the form of stronger border controls — were likely to now be insufficient measures on their own.
“Additional measures at the border might provide some further incremental protection, and it might slow down the introduction of more of this (variant), or other variants,” Bogoch said. “But this is already here, and it’s circulating.”
Any additional measures at the borders shouldn’t distract the province from keeping transmission under control within its borders, Bogoch said, including focusing on the “huge” equity-related issues of infection risk.
“There’s no magic, right? We know how to control this,” adding that evidence shows COVID-19 vaccines are still effective against the U.K. variant.
Gardner said that in addition to strict adherence to the province’s current stay-at-home order, he believes Ontario needs more stringent controls on travel between jurisdictions — measures he acknowledges would be unpopular, but were used successfully in Australia.
“I think that movement in the population is a problem… You’ve got a lot of transmission happening between jurisdictions,” said Gardner, a member of the province’s public health measures table.