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Frontline workers at Apotex line up to get their COVID-19 vaccinations through a mobile vaccination clinic set up by Humber River Hospital during the COVID-19 pandemic in Toronto on April 9, 2021.Nathan Denette/The Canadian Press

York Region’s medical officer of health, who just over a month ago predicted that his area would escape a third wave of COVID-19, now says his earlier optimistic forecast was based on receiving more vaccines to outrun the virus’s new, more contagious variants.

Karim Kurji has frequently stood apart from his peers in neighbouring Toronto and Peel Region, expressing skepticism over the effectiveness of lockdowns and arguing that more businesses should be allowed to reopen.

Until the province’s latest moves to bring in a stay-at-home order, he managed to keep his sprawling health district north of Toronto under a looser level of restrictions, allowing restaurants to reopen with capacity limits.

COVID-19 news: Updates and essential resources about the pandemic

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

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

Canada vaccine tracker: How many COVID-19 doses have been administered so far?

And in early March, Dr. Kurji told The Globe and Mail that new and more contagious variants of the virus were not spreading as fast as anticipated. While cases would likely rise again, he said that he didn’t believe York would see the “explosive growth” of a third wave.

It didn’t work out that way. Ontario registered 4,227 new infections on Friday, with York Region responsible for 532 cases – well past the area’s January high-water mark in the second wave. The province’s hospitals warned that intensive-care units were reaching a breaking point.

In an interview on Friday, Dr. Kurji said that in March he believed the vaccine rollout would head off any major increase in cases – but that a lack of supply slowed progress.

“I agree we are definitely in the third wave,” he said. “But when we were looking at the data at that time, I wasn’t that convinced that we were going to get into a third wave. And I’ve always found that predicting anything seems to be really difficult.”

Dr. Kurji says he supports the province’s new stay-at-home order, which has shut restaurants and non-essential retail to in-person customers for four weeks. Similar measures appeared to work at the height of the second wave in January, he said.

But he also said that he remains skeptical of the effect of the province’s system of colour-coded lockdown levels. He says the epidemic curves in Toronto and Peel, which had tougher restrictions in the grey or “lockdown zone,” were not much different than York’s, which had stayed in the less-restrictive red zone. His strategy was to instead vigorously enforce pandemic rules and launch inspection blitzes of businesses.

Dr. Kurji said there are reasons for optimism, with the new focus on vaccinating younger people in community hot spots. In York Region, he said, the new variants appear to have plateaued at 50 to 60 per cent of infections, and the time they take to double has increased to 12 days, meaning they are moving more slowly. It’s different than in the rest of the province, he said, where the variants are doubling every nine days.

He said the new vaccination push should start to make a dent in case counts within two to four weeks. Part of the problem, he said, was that vaccinations so far have focused on older people, while younger people have been transmitting the new variants.

“We had to move from what I like to call a defensive strategy, to protect older and vulnerable folks, to the offensive strategy, which is really trying to put out the fires that are raging,” Dr. Kurji said.

Starting on Monday, mobile teams will begin vaccinating workers aged 18 and up at 14 targeted manufacturing plants in York Region, which were chosen based on outbreak data. Dr. Kurji said many of the employees who will get the shot actually live in Toronto or Peel. Vaccinations at clinics in York Region for those living in certain hot spots and aged 45 to 59 are already under way.

He acknowledged that York Region’s hospitals were under immense stress, and have been accepting overflow patients from other areas, including Toronto and Peel. But he said the number of admissions for cases actually originating in York Region was holding steady, and the percentage of York Region residents ending up in ICUs had declined.

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