Adalsteinn Brown, co-chair of Ontario’s science table and dean of the Dalla Lana School of Public Health, answers questions during a news conference at Queen's Park in Toronto on April 20, 2020.Frank Gunn/The Canadian Press
Days before Premier Doug Ford’s government was set to end Ontario’s stay-at-home order for most of the province, Adalsteinn Brown presented new COVID-19 modelling that showed lifting public-health measures could lead to a sharp rise in cases fuelled by more contagious variants of the virus.
Dr. Brown, co-chair of Ontario’s science table who puts forward new coronavirus trends at a press conference every two weeks, was questioned at the time by a reporter who wondered if he was missing something or if the presentation was actually predicting a disaster.
In his characteristically deadpan tone, Dr. Brown replied: “No, I don’t think you’re missing anything.”
COVID-19 news: Updates and essential resources about the pandemic
Tracking Canada’s COVID-19 vaccine rollout plans: A continuing guide
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
The Feb. 11 exchange went viral, momentarily turning Dr. Brown, who goes by the first name Steini, into an internet sensation.
Weeks later, the province has averted the worst outcomes by not fully reopening, Dr. Brown said, although variants of concern are spreading and cases are rising in most public-health units.
“Right now we’re basically in the middle of a minefield,” Dr. Brown said during a recent interview with The Globe and Mail.
“I know everyone hates them, and I hate them too, but the prolonged shutdowns in Toronto and Peel I think really helped blunt some of this. … There’s still a lot at risk.”
Blunt is also how many would describe Dr. Brown – a straight-talking scientist who stands in stark contrast to the verbosity of Ontario’s Chief Medical Officer of Health, David Williams.
As head of Ontario’s science table, a group of academics and experts, Dr. Brown has emerged as one of the most prominent voices of the pandemic, even though he’s not exactly sure how he ended up being the public face of provincial modelling.
“I don’t know … and I hate it,” Dr. Brown said. “Almost any answer, any direction, has huge consequences.”
Dr. Brown, dean at the Dalla Lana School of Public Health at the University of Toronto, doesn’t report to anyone in government, beyond relaying the findings of the COVID-19 modelling group’s work to cabinet. “It doesn’t have an approval process, so there’s no consequences that way,” Dr. Brown said. His next presentation is on Thursday.
He’s not afraid to call for stronger measures. Case in point: He says the province’s current sick-pay policies – bolstered by a federal government program – are inadequate. A study in Peel showed close to 25 per cent of those surveyed were on the job while infected with the virus between August and January.
While it makes things politically difficult, his directness has earned Dr. Brown the admiration of the Premier’s Office.
“While at times he has had to deliver tough news, he has always done so calmly and honestly. In doing so, he has built enduring trust with the people of Ontario,” said Travis Kann, Mr. Ford’s executive director of communications.
But Dr. Brown, along with other medical modellers, has also attracted criticisms from those who argue the pandemic’s worst-case scenarios have failed to materialize, resulting in widespread business closings that have devastated people’s livelihoods.
He is keenly aware of the impact lockdowns have had – “I get those e-mails,” he said, about critics of his work. But he says it’s his job to communicate to the public all that could happen, but not necessarily will.
“The modelling doesn’t say, this is going to happen regardless of what you do. The modelling says, this is what will happen if you don’t do anything,” he said. “Generally, there’s a change in what the actions are.” What he’s watching for these days, he said, is how quickly vaccines can be deployed to prevent the worst outcomes of a third surge.
Dr. Brown, 50, grew up in London, Ont., the son of a doctor and nurse. He said his mother, vice-president of nursing at a hospital in her 20s, quit on principle in the 1960s over inappropriate relations between doctors and nurses and allegations of sexual assault. She never went back. He followed his family’s footsteps into health policy, earning degrees from Harvard and Oxford Universities, working in the private sector in the United States and returning to Canada to take on various roles with hospitals, the government and academia.
A father of two, he survived cancer at the age of 29, and even believes he had COVID-19 in January, 2020. But he couldn’t get a test at that time.
His commanding performance has some wondering if he’d replace Dr. Williams when the top doctor’s term is up at the end of September. Dr. Brown says he’s not suited for the position because he’s not a clinician. And also: “I never want that job.”
For his part, Dr. Brown has repeatedly said that he’s not in charge. Nor should he be.
“You want a world where the science is always out publicly. You wouldn’t want a world where the scientists are telling you what to do at every step,” he said.
“When this is all over, I’ll continue working as a researcher, and I’ll continue working as an academic administrator, but the government will need to go back to the polls. They’ve got a very different issue they have to deal with.”
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Laura Stone