Ask the Pharmacist: More COVID news

Q) I don’t know what to make of the news these days; On one hand, much of what I hear seems optimistic but then I listened to a doctor heeding warnings of the third wave that is just around the corner. Are things actually getting better or worse?

A) That’s a really good question these days. It is true that there is no shortage of positive headlines. Most regions in Ontario and elsewhere are opening up again although at the same time a few regions are trending the other way.  As you likely know, Grey Bruce Public Health area is back in the green level of restrictions which is as close to normal as we have come since this all began a year ago.

The partial reopening of the economy is reflected in the economic news we have received recently. Not only did the economy add 259,000 jobs in February, the largest increase in many months, but unemployment fell by a full percent to 8.2%. Even better, most of the added jobs have been in the hardest hit sectors such as retail, accommodation and food services which disproportionately employ a larger share of females, immigrants and workers of colour. These are all groups of people who could use some good news on the job front even more than the rest of us.

As well, vaccines continue to pour into Canada quicker (finally…) than we had expected them to based upon February’s headlines. We should soon be getting a million doses a week of the Pfizer vaccine and the 4th approved vaccine, the Johnson & Johnson version, should soon be aiding in our fight.

Most of our seniors in long term care homes have already received at least one dose of a vaccine as have many front line health care workers and people living in remote indigenous communities. Next in line are the 80 plus crowd and some regions are already well into vaccinating this group as well. Yet in spite of all this positive news, storm clouds gather on the horizon.

Experts are predicting a third wave is already upon us and that new shut-downs, perhaps even more drastic than previous ones (think curfews and the like), will be necessary to preserve lives. This is backed up by the numbers. Canada wide, as of March 13th, 21,566 new cases of the coronavirus were reported in the last 7 days which is up 8% from the previous week. The numbers are far worse in Ontario where the number of new cases rose by a startling 29% in the same week. Sudbury and Manitoulin can serve as a guide to show just how bad this can get seemingly overnight.

Public health reported 55 new positive cases in one day last Thursday, a record number, and is seeing 72 new cases per 100,000 as compared to 12 just two weeks ago. Half of these have screened positive for the far more contagious new variants which have now collectively been given their own moniker, variants of concern (or VOC). Sudbury has responded by completely shutting down and even closing their schools amidst 12 active outbreaks, of which six are in schools.

The reasonable question to ask is how can all of this positive and negative news be happening at the same time? Experts explain that there are two main reasons for this. Firstly, we still have not vaccinated nearly enough people to come close to achieving herd immunity. Secondly, scientists now believe that we are actually dealing with two pandemics occurring simultaneously. There is the one that started a year ago this month with the original version of the virus that is starting to peter out as reflected by all the positive news we are hearing.

Then there is the second pandemic which is being fuelled by variants of the COVID-19 viruses that originated in such far off places as Brazil, South Africa and the United Kingdom and have made their way to our shores. These variants are all far more contagious (in the range of 40 to 50% higher) than the original version.

To understand why, just when things are beginning to look so bright, that we are likely going to experience a harder, tougher time, we will have to do some math math (I know ugh…). Taking our numbers from January when the government locked the province completely down, we reduced the virus’ reproductive number (R0) to somewhere between 0.7 to 0.8. Recall from our previous articles that any R0 number below 1 means that the virus is shrinking in its impact. Now take this 0.7 and multiply it by our best case estimate that the new variants are at least 40% more infectious and you have a new R0 of at least 1 and probably higher, meaning that case counts will go up. Combine this with the reopening of society and we find ourselves amongst cities shutting down once again.

On an interesting note, Sudbury wasn’t as open as we are as they only reopened to the red level. Projections for Ontario that were made on February 25th predicted Ontario hitting 4,000 cases a day by the end of this month which would exceed the peak of the second wave. As of March 11th our case numbers were actually tracking higher than the worst-case scenario presented in that modelling. It is estimated that 40% of all Ontario’s new cases are due to VOC.

To make matters more grim, there is also credible evidence that besides being more contagious these new variants bring additional challenges to us. Evidence is mounting that the B1.1.7 variant first discovered in the U.K. is also more lethal than the original virus. According to an article published last week in the British Medical Journal, this variant increases the chances of death in those it infects by somewhere between 30 to 100 percent. There is also data indicating that the other variants may be less likely to either respond to our current vaccines (in the case of the South African one B.1.351) or to reinfect those that have previously recovered from COVID-19 (as is happening in Brazil with the P.1 variant).

All of this is obviously not great news and can be frustrating to hear given all that we have already lost and sacrificed. Eventually, the vaccines will lead us out of these troubled times but time is of the essence and we are still nowhere close to achieving our goal of herd immunity. What happens next is critical. The third wave is here. If numbers take off we will all have to do our part by restricting our activities once again.

There was a time when we looked at our world differently. We were asked to support and care for our country such as when we went to two world wars overseas. Nowadays, it seems like many of us are only interested in what Canada can do for us in terms of money in our pockets and new freedoms and capabilities. Our country should be benefitting us, but it has to be a symbiotic relationship for us to thrive as a nation. For more information about this or any other topic contact your pharmacist.