N.L. in 'race' between injections and infections as province reports another day with no new COVID-19 cases

There are no new cases of COVID-19 in Newfoundland and Labrador on Wednesday, with nine more recoveries, leaving 36 active cases in the province.

Dr. Proton Rahman, who heads the province's COVID-19 data modelling team, joined Wednesday's live briefing with the latest COVID-19 modelling numbers for the province.

Rahman, a clinical scientist with Eastern Health and professor of medicine at Memorial University, said about 49 per cent of new cases in Ontario are being reported as the coronavirus variant B117, and the province is predicting a third wave.

"It's reasonable to assume that if the numbers go up in Ontario, because a lot of our importations are from that province, we're going to see more cases. For every case that lands at our border from Ontario from now on there's a 50 per cent chance that they will have the B117 variant," he said. 

Rahman said it's important to listen to the advice of Chief Medical Officer of Health Dr. Janice Fitzgerald and her team as the province has been able to manage and contain the recent outbreak of the variant in the St. John's metro area with stringent guidelines. 

"They're guiding you based on the epidemiology they see within the province, and what they see outside of the province as well," Rahman said. 

"Essentially now it's a race, isn't it? It's a race between injections or vaccinations and infections, and to really help secure the win what we really need to do is to keep the infections as low as possible so that we can vaccinate many individuals."

Watch the full March 17 update:

Rahman said that while the province has responded well to the B117 outbreak, more cases are to be expected and shouldn't come as a surprise.

"The B117 variant, as we've seen, can spread very quickly. But the public health measures are quite effective in controlling the spread of all variants," he said. 

"It's the same things that we have to do, but we have to be vigilant, and this continued vigilance is needed to maintain minimal community transmission and to minimize the probability of further outbreaks."

Rahman said the U.K., where the variant was discovered, is reporting that not only is it more transmissible, but also more severe.

"In following the literature, I'm pretty convinced that it's actually a more severe variant in terms of complications," he said.

Fitzgerald said any new cases that come into Newfoundland and Labrador as a result of travel are tested for coronavirus variants through whole-genome sequencing in the province's public health laboratory. She said the analysis of those cases is being done in the province and then is validated by the National Microbiology Laboratory in Winnipeg. Fitzgerald said whole-genome sequencing has been done in the province's lab since Monday.

Variants mean vigilance 

In early April, in the early days of the pandemic, Rahman presented two scenarios. One projected 32 per cent of Newfoundlanders and Labradorians infected over a two-year period, exceeding intensive-care capacity by the end of the following June and peaking in November. The second model projected a scenario that assumed 52 per cent of people in the province infected over the same two-year period. In that scenario, the peak came sooner — mid-September — and overwhelmed hospital beds, intensive-care units and ventilators.

Newfoundland and Labrador avoided its second peak until mid-February this year, when an outbreak saw — at its highest point — 434 active cases, on Feb. 20. 

Rahman said what surprised him most about the recent outbreak was how quickly the B117 variant had spread and how many cases were asymptomatic. But he said he was also "pleasantly surprised" by how the public reacted to it, particularly the younger population. 

"We need to really respect the virus, but also have confidence that with correct public health measures we can take control of the situation," he said.

Fitzgerald said there were events that happened over the first weekend of February that resulted in the spread of the variant, including several sporting events and other events involving young people, and then spread to their households. 

Fitzgerald said the most recent data gathered on the latest outbreak, variants of concern and a significant number of cases found with mild or no symptoms means the province has to be more vigilant.

"We do have to take that into account when we're looking at relaxing these public health measures and moving forward," she said. "We really have to think about this as we're relaxing our measures in the face of a more transmissible variant, and so we have to do it accordingly. That does mean we have to look at gathering sizes more carefully."

Given N.L.'s large population of rotational workers entering and leaving the province on turnarounds, Fitzgerald said, the 50 per cent chance that an imported case is the variant is a big concern.

"It's mainly the reason why we have instituted testing for rotational workers, because we know that by the time somebody becomes symptomatic with, say the B117 variant, their contacts may already be spreading it," she said. 

"We saw that in this outbreak, we also saw situations where people did not become symptomatic until quite late in the incubation period."

Premier Andrew Furey said the Department of Health shared Rahman's modelling Wednesday because the last time models were presented was also after an outbreak.

"It takes time to see the data in order to determine modelling, so it was an appropriate amount of time for Dr. Rahman to present the current modelling in terms of projections and how we did," Furey said. 

"No different than after the Caul's cluster. There was a little bit of time before he presented."

More recoveries, more vaccinations

Eight of Wednesday's recoveries were in the Eastern Health region, while the remaining one was Labrador-Grenfell Health's sole case. All active cases are now in the Eastern Health area. 

Two people are in hospital due to the virus. 

To date, 120,946 people have been tested, including 302 since Tuesday's update.

Health Minister John Haggie said 36,642 people in the province have been vaccinated with at least one dose of COVID-19 vaccine so far. 

Phase 1 of the vaccine rollout strategy is nearing its end, said the health minister.

"Phase 2 is already starting, and we've seen that with some of the AstraZeneca [vaccine] that started being distributed yesterday and administered to Central Health first responders," Haggie said.  

Eastern Health and Western Health are also beginning to vaccinate first responders this week. Fitzgerald said Labrador-Grenfell Health will begin vaccinating first responders on Monday. 

Central, Western and Eastern Health are offering vaccinations to those over 80 years old this week, and are expected to start vaccinations of people over 70 years old by the end of the month, said Fitzgerald.

She said Labrador-Grenfell Health anticipates completing vaccinations for people over 70 years old by early next week, and will begin administering doses to adults in Indigenous communities in the first week of April.

Five days into lowered alert levels across the province, Fitzgerald said public health will need the full two-week period to determine if there has been any COVID-19 transmission from increased movement of residents. 

"We will be carefully monitoring this over the next week," she said. 

Fitzgerald said she, her team and Eastern Health staff are relieved to see the active caseload subside but will continue to watch the situation carefully until the province is sufficiently vaccinated.

"It was in no small part a collective effort by everybody who abided by the measures and really worked hard to make sure we reduced the spread as much as possible," she said.  

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