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A passenger from New Delhi arrives at Pearson Airport in Toronto on April 21, 2021.Frank Gunn/The Canadian Press

British Columbia’s top public health official expressed relief on Thursday after Ottawa said it would suspend passenger flights from India and Pakistan, noting the province has already identified 40 cases of B.1.617, the “double variant” of COVID-19 that was first detected in India.

Dr. Bonnie Henry, Provincial Health Officer, said cases of the variant have been in B.C. for two months. While B.1.617 has not been declared a variant of concern, the overwhelming rise in COVID-19 cases in India has raised the alarm about a potentially more transmissible variant, and B.C. is urgently trying to contain those cases while research continues.

“It is tragedy globally, that we are seeing, and India is bearing the brunt of it right now,” Dr. Henry told reporters. She said B.C. had urged Ottawa to restrict travel from India, especially because of troubling gaps in the federal quarantine program for international arrivals.

‘Variant of interest’ vs. ‘variant of concern’: What’s the difference?

SARS-CoV-2, the virus that causes COVID-19, has mutated into many new forms since the pandemic began. Some are more transmissible than the original virus, or more likely to reinfect people who recovered from it, but health officials don’t treat all variants as serious threats unless they meet certain criteria.

VARIANT OF INTEREST

  • Definition: To the World Health Organization, a variant of interest, or VOI, is simply a form of the virus that’s shown to have different physical properties than classic SARS-CoV-2, or have new genes that could make it so. The shape of viruses, in particular the protein spikes they use to bind to host cells, is important because a variant with different spikes could be better able to infect cells or resist antibodies. But until researchers can prove that a given variant does those things, it remains a VOI. When national health agencies find a new one, they have to share its gene sequence and case details with their local WHO office. The WHO then gives it a Greek letter designation.
  • Examples: Iota is a variant that emerged in New York in the fall of 2020. It showed some resistance to the antibody drugs used to treat severe COVID-19 cases, but WHO guidance says it’s unclear what clinical effect that really has.

VARIANT OF CONCERN

  • Definition: VOCs are types of VOI that have been confirmed as more transmissible or more resistant to existing public-health measures. The vaccines we have now, for instance, are still mostly effective against all forms of COVID-19, but non-medical masks and physical distancing can be less effective because, if the virus is more contagious, it would take a smaller amount of virus-carrying water droplets in the air to spread it from person to person.
  • Examples: The WHO’s list of VOCs so far includes the variants first identified in Britain (Alpha), South Africa (Beta), Brazil (Gamma), India (Delta), California (Epsilon) and Peru (Lambda). All have had documented cases in Canada, though Alpha is by far the most common type.

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“We are struggling with our own third wave across this country right now, and so anything that we can do that stops further introductions into the country is really, really important,” she said.

B.C. has called on Ottawa to step up enforcement of its 14-day quarantine program. As of April 20, the Public Health Agency of Canada has recorded 404 tickets that have been issued to travellers who have arrived in Canada and refused to stay in the required, government-approved accommodation. Vancouver International Airport is one of four airports in Canada accepting international flights.

In B.C., the third wave of the pandemic is pushing hospital capacity to the limit, and nine major hospitals in the Lower Mainland will cut back to urgent and emergency surgery only for the next two weeks, resulting in the cancellation of 1,750 scheduled operations, to provide critical care staff with some breathing room.

As well, on Friday, British Columbians will face new travel rules designed to stop leisure travel between communities for the next five weeks. The enforcement details will be announced on Friday, and Dr. Henry said she expects the latest measures, combined with the COVID-19 vaccination program, will allow the province to lift some pandemic restrictions by July 1.

However, new modelling from Simon Fraser University suggests British Columbia will likely have to continue physical distancing and other measures well past the summer.

The SFU report released this week argues that B.C. will not achieve herd immunity in the coming months, in large part because the vaccine plan leaves out everyone under the age of 18. To roll back pandemic health restrictions before that point will lead to substantial hospitalizations and infections, researchers Paul Tupper and Caroline Colijn concluded.

“The only way things can return to normal in B.C. is if a large portion of our population obtains immunity to the virus, either through infection or through vaccination,” the authors note.

The B.C. vaccine plan promises to provide every adult at least their first dose of the vaccine by the end of June. That’s not enough, the study found.

“We need 60 per cent of the population to be protected by vaccination. Unfortunately, about 80 per cent of the population is adult, of those only about 80 per cent will get vaccinated, and of those, the vaccine may be effective against infection for only around 80 per cent ... This gives a total percentage of only 51 per cent protected from infection.”

However Dr. Henry said real-world experience has been more positive. “The U.K. is a very good example where we have seen dramatic decreases in transmission after a single dose of vaccine at a rate of about 50 to 60 per cent of the population,” she said. “It means that we can have small clusters and outbreaks that we can manage through the public health measures that we know work.”

She said B.C. should be able to relax some of its current restrictions on social gatherings over the summer, although she cautioned the postpandemic world will not look the same as before the pandemic. “If we keep going with what we’re doing, and people pay attention right now to stopping your connections with others, so that we can get there by the first of July – we’ll be able to start slowly and cautiously, having those connections again.”

Dr. Henry added that B.C. could open up its COVID-19 immunization program to younger residents by the fall. The Pfizer vaccine is already approved for use in people as young as 16, and she said several studies are in progress that could pave the way for even younger recipients.

“I do believe that by next fall we’re likely to have a vaccine available for children, particularly for teenagers who are most at risk.”

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