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New Brunswick, with one of the slowest COVID-19 vaccination rollouts in the country, is racing to give thousands of nursing home residents their first doses this week.

Long-term care homes have accounted for 17 of the province’s 26 coronavirus deaths, yet many of the residents were waiting for their vaccinations weeks after health care workers had theirs. Of the more than 11,000 people who have been fully vaccinated in the province, fewer than 15 per cent come from this most vulnerable population.

As of Wednesday, New Brunswick had administered more than 26,000 total doses, to about 3.4 per cent of the province’s population. Most of those inoculated have been health care workers – 9,395 have received both doses, while 1,626 long-term care residents have been fully vaccinated.

With a mass expansion of the COVID-19 vaccine program just weeks away, are provinces ready for the rollout?

Coronavirus tracker: How many COVID-19 cases are there in Canada and worldwide? The latest maps and charts

After growing criticism, the province adjusted its approach. This week and next, it plans on delivering doses to 8,800 residents and staff at 321 long-term care residences – and the provincial government said all licensed nursing homes should have received their first doses by mid-March.

Which COVID-19 ‘variants of concern’ are in Canada? Alpha, Beta, Gamma, Delta and Lambda explained

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.

ALPHA (B.1.1.7)

  • 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.

BETA (B.1.351)

  • 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.

GAMMA (P.1)

  • 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.

LAMBDA (C.37)

  • 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 audience@globeandmail.com

In Nova Scotia, only 955 long-term care residents had been fully vaccinated by Feb. 23 – compared to more than 10,000 health care workers, according to government data. Yet nursing home residents have accounted for 57 of 65 deaths.

Some families are angry the provinces appear to have prioritized public-sector employees in the early stages of vaccination.

“It doesn’t make any sense,” said Greg Losely, whose wife, Carol, lives in the Kiwanis Nursing Home in Sussex, N.B. “They keep saying the nursing home people are the most vulnerable. Well, if that’s the case, shouldn’t they get the vaccines first?”

His wife, 71, has multiple sclerosis and requires full-time care. She’s immuno-compromised, and has left the 70-bed facility only twice since last March, to visit the dentist. It’s been an anxious time with only limited opportunities to visit, Mr. Losely said.

“My wife is begging me to take her home,” he said. “She doesn’t feel safe in there.”

The Atlantic provinces have taken different approaches. Prince Edward Island, which has one of the highest rates of vaccination among provinces, has used about 90 per cent of its available doses.

Nova Scotia and Newfoundland and Labrador, which have larger stockpiles, have been among the slowest to vaccinate – at around 3 per cent and 3.2 per cent of their populations, respectively. That’s according to public data comparing vaccines delivered from Ottawa with provincially reported doses administered.

Nova Scotia focused on vaccinations in long-term care homes a few weeks ago, and this week is targeting people who are 80 and older in the general population. The provincial government says 2,205 residents of nursing homes have received their first dose.

Rates of COVID-19 infection have been lower in the Atlantic region as a whole than in the rest of Canada, despite recent outbreaks.

In some cases, the type of vaccines available have determined who goes first. Nova Scotia has used the Moderna vaccine in its long-term care homes, and the Pfizer-BioNTech product at off-site vaccination clinics. Nursing homes do not have the necessary ultracold storage equipment for the Pfizer shot, so staff in some facilities got their first shots off-site while residents waited for Moderna. As well, vaccine supplies were delayed in Nova Scotia and New Brunswick after shipments were rerouted to Canada’s North.

The New Brunswick government announced last week it would delay administering the second dose for those considered at a lower risk. It pledged to vaccinate all long-term care residents, front-line health care staff, First Nations adults and people 85 years and over by the end of March.

“We must broaden the scope of our vaccine campaign to ensure we do protect those most vulnerable,” said Jennifer Russell, New Brunswick’s Chief Medical Officer of Health.

Thousands of older New Brunswickers who don’t live in long-term care are still waiting to find out how and when they can apply to be vaccinated.

“We asked our doctor when we could expect the vaccine,” said Alphonse Dionne, 78, president of the New Brunswick Senior Citizens Federation. “She told us she doesn’t know any more than we do.

“That part is very disappointing. But I realize we’re at the mercy of those vaccine shipments, and we’re not producing any in Canada.”

New Brunswick says it expects to be able to provide a second dose to people over 70 starting in June. That’s a delay from earlier timelines, in part because of a new plan to begin vaccinating students aged 16 to 24 that month, in response to a recent outbreak in Newfoundland that began with high-school students.

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