JJ Elliott swears he follows the rules. He wore a mask before they were mandatory. He pulls it up over his face when he nears someone walking around Wascana Centre, a massive park in Regina. It irks him when people ignore the directional arrows in grocery stores, mucking up physical-distancing protocols. If he goes to a pub, he wears a mask and washes his hands. But still, after a year of staying home and taking precautions, the coronavirus infected Mr. Elliott this month.
Mr. Elliott is one of Regina’s 867 active cases of COVID-19, which is sweeping Saskatchewan’s capital owing to the virus’ more transmissible variants. Mr. Elliott knows neither where he contracted the virus nor whether it was a variant of concern, but he attributes his infection to Regina’s overall situation: “Way out of control,” the 44-year-old said.
Regina has emerged as a case study in how swiftly variant strains of the coronavirus can upend efforts to contain COVID-19. Active cases of COVID-19 in Regina doubled over the past month, compared with a drop of 40 per cent in Saskatoon, for example. In Regina, more people who are relatively healthy and young are ending up in hospital compared with the past year. The variants defy previously effective public-health measures such as distancing and masking, according to experts.
COVID-19 is caused by a virus called SARS-CoV-2, and as it spread around the world, it mutated into new forms that are more quickly and easily transmitted through small water droplets in the air. Canadian health officials are most worried about variants that can slip past human immune systems because of a different shape in the spiky protein that latches onto our cells. The bigger fear is that future mutations could be vaccine-resistant, which would make it necessary to tweak existing drugs or develop a new “multivalent” vaccine that works against many types, which could take months or years.
Not all variants are considered equal threats: Only those proven to be more contagious or resistant to physical-distancing measures are considered by the World Health Organization to be “variants of concern.” Five of these been found in Canada so far. The WHO refers to them by a sequence of letters and numbers known as Pango nomenclature, but in May of 2021, it also assigned them Greek letters that experts felt would be easier to remember.
- Country of origin: Britain
- Traits: Pfizer-BioNTech and Moderna vaccines are still mostly effective against it, studies suggest, but for full protection, the booster is essential: With only a first dose, the effectiveness is only about 66 per cent.
- Spread in Canada: First detected in Ontario’s Durham Region in December. It is now Canada’s most common variant type. Every province has had at least one case; Ontario, Quebec and the western provinces have had thousands.
- Country of origin: South Africa
- Traits: Some vaccines (including Pfizer’s and Oxford-AstraZeneca’s) appear to be less effective but researchers are still trying to learn more and make sure future versions of their drugs can be modified to fight it.
- Spread in Canada: First case recorded in Mississauga in February. All but a few provinces have had at least one case, but nowhere near as many as B.1.1.7.
- Country of origin: Brazil
- Traits: Potentially able to reinfect people who’ve recovered from COVID-19.
- Spread in Canada: B.C. has had hundreds of cases, the largest known concentration of P.1 outside Brazil. More outbreaks have been detected in Ontario and the Prairies.
DELTA (B.1.617 AND B.1.617.2)
- Country of origin: India
- Traits: Spreads more easily. Single-dosed people are less protected against it than those with both vaccine doses.
- Spread in Canada: All but a few provinces have recorded cases, but B.C.’s total has been the largest so far.
- Country of origin: Peru
- Traits: Spreads more easily. Health officials had been monitoring it since last August, but the WHO only designated it a variant of concern in June of 2021.
- Spread in Canada: A handful of travel-related cases were first detected in early July.
If I’m sick, how do I know whether I have a variant?
Health officials need to genetically sequence test samples to see whether it’s the regular virus or a variant, and not everyone’s sample will get screened. It’s safe to assume that, whatever the official variant tallies are in your province, the real numbers are higher. But for your purposes, it doesn’t matter whether you contract a variant or not: Act as though you’re highly contagious, and that you have been since before your symptoms appeared (remember, COVID-19 can be spread asymptomatically). Self-isolate for two weeks. If you have the COVID Alert app, use it to report your test result so others who may have been exposed to you will know to take precautions.
Need more answers? Email firstname.lastname@example.org
“Don’t believe what’s happening here is not going to happen everywhere else,” said Alex Wong, an infectious-diseases physician working on the frontlines in Regina. “Better to just go through this last hard push – six to eight weeks – and then we’re over it, and then hopefully we will be in a new normal.”
The explosion of COVID-19 cases in Regina forced the provincial government to tighten restrictions in the capital and surrounding communities.
Saskatchewan has identified 1,155 cases of variants of concern through its screening program throughout the pandemic. Of those, 973 cases stemmed from the Regina zone, according to data released Friday. B.1.1.7, the variant of concern originally identified in Britain, makes up the vast majority of mutated cases. There are 155 COVID-19 patients in hospital across the province, including 24 intensive-care unit admissions. In the Regina zone, 70 people with COVID-19 are in the hospital and 16 of those are in ICU.
Dr. Wong said there was a belief Regina’s variant cases would lag other urban areas because fewer of the city’s residents travel internationally compared with centres such as Toronto or Calgary. But Saskatchewan retrospectively screened Regina’s COVID-19-positive samples from February and early March and the results showed roughly 78 per cent of those COVID-19 infections were tied to variants, Dr. Wong said.
“We were like: ‘Oh, shoot.’”
The variants, along with the early phase of the vaccination campaign, which targeted elderly citizens, are changing hospital demographics, according to experts. Of the 35 ICU admissions in Regina over the past month, only one person was over 70, according to Scott Livingstone, the chief executive officer of Saskatchewan Health Authority. Further, people under 40 make up half of the past 10 ICU admissions, the executive told reporters Thursday.
“These past few weeks, we are being tested in a way we have not been tested through the pandemic,” he said.
Alyson Kelvin, a virologist at the University of Saskatchewan’s Vaccine Infectious Disease Organization, said health measures that worked last year are not enough to contain the variant strains.
“The variants are playing by different rules,” she said. “The transmission dynamics are not the same.”
Saskatchewan directed its allotment of the Oxford-AstraZeneca vaccine to drive-through clinics in Regina in an effort to tame the spread. Premier Scott Moe on Tuesday announced targeted restrictions for Regina and other parts of southern Saskatchewan. Under the new restrictions, private indoor gatherings are prohibited and travel in and out of Regina is not recommended. Further, as of Sunday, restaurants are limited to take-out and delivery and other indoor event venues will have to shut their doors until at least April 5.
“This is exactly what I didn’t want to do,” Mr. Moe said. Regina said that starting Sunday its community and recreational centres were to be closed. Regina Public Schools and the Regina Catholic School Division are moving students to online learning ahead of spring break because of the variant spread.
Andrew Cameron, a professor at the University of Regina’s Institute for Microbial Systems and Society, said Regina’s situation underscores the importance of vaccinating as many people as quickly as possible.
“The race is on and we’re losing,” he said. “The longer we let this go, the more variants that can emerge.”
With a report from The Canadian Press
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Editor’s note: A previous version of this story included an incorrect spelling of JJ Elliott's surname.