Front Burner - Delta variant: What you need to know

Episode Date: June 14, 2021

As much of Canada begins easing pandemic restrictions, we look into the delta variant. It’s a COVID-19 strain that’s concerning experts and emerging all over the country, from a hospital in Calgary, hotspots in Ontario and a mine in Nunavut. Global health epidemiologist Raywat Deonandan weighs in on the latest.

In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. This is a CBC Podcast. Hi, I'm Jamie Poisson. So maybe you're feeling this sense of relief right now, elation maybe, as patios and gyms are opening in many places in the country as restrictions and lockdowns ease. But here's the thing. Only about 8% of the population is fully vaccinated right now, and there is this growing concern about a new strain of COVID, the Delta variant,

which was first identified in India. It's popping up all over. The Toronto Star reported this weekend that a massive outbreak at a mine in Nunavut is now connected to cases all across the country. There's an outbreak at a Calgary hospital, lots of cases percolating in Ontario, particularly in the GTA. So what exactly do we know about the Delta variant and how concerned should we be? With me today is Rawat Dianandan. He's a global health epidemiologist and an associate professor at the University of Ottawa. Hey, Ray, thanks so much for coming back on the podcast. It is my absolute pleasure.

It is an absolute pleasure for us to have you. Although I feel like before we get started, we should acknowledge that the goal of this conversation is not to like bomb everybody out, right? There's a lot of optimism here, a lot of it. So let's remember that. Okay, good, good. I'm hoping that we can hit on some of that today. So before we get into what we know about this variant, I wonder if you could just big picture, tell me how concerned you are about the Delta variant in Canada. It's a little concerning. Last time we spoke, I talked about the pandemic as a action movie in three acts. And that third act was the third wave. And we shouldn't have to deal with anything else after that.

But sometimes there are. Yes, I remember this very well. Sometimes there are direct-to-DVD sequels, right? And this might be something like that. And the direct-to-DVD sequels, right? And this might be something like that. And the direct-to-DVD sequel isn't well-watched, isn't well-reviewed, and often it's kind of boring. So there's a possibility that if there is a fourth wave, it'll be driven by this variant. And if we do everything right, there won't be one. And if we do most things right, then this fourth wave might not be noticeable.

So I'm moderately concerned. And we have lessons from around the world telling us exactly what we need to do to prevent this from being a larger concern, hence the optimism. Okay. Well, let's talk about that then, how we can prevent this, or at the very least, I guess, opt for the very boring straight to DVD sequel. How prevalent is this variant in Canada right now? It's a difficult question to answer. And the reason for that is we don't really do good surveillance for this variant because it has multiple mutations. The previous variants, like the so-called alpha variant, was a little more easy to detect. This is more difficult.

And many of the public health labs across the country aren't well-equipped to detect it. So the answer is we don't know. However, we think that in hot spot places like Peel in Toronto, it may be responsible for 30% of new cases. And as we've seen from around the world, it doesn't take a lot for this variant to suddenly become dominant. So to that extent, it is concerning. And you mentioned what you see from around the world. I'm assuming maybe you're talking about the UK right now. And I wonder if you could tell me what's happening there. Right. So back in April, the Delta variant was responsible for about 1% of cases. Now it's 90%. So explosive growth happening there. So obviously, it is the dominant variant in that country. And it is leading to exponential growth,

at least in that particular category of people who are getting it. British Prime Minister Boris Johnson is facing a difficult decision on whether to reopen the country on June 21st. Johnson had hoped to lift all lockdown measures in England in nine days time on Freedom Day, as it was dubbed. Yeah, there's a risk, obviously, that the Delta variant could cause a significant increase in infection if you let it. But the good news is that of those who are getting sick with this disease, only 5% have been fully vaccinated and 22% have had only one dose, which means the majority of these cases are amongst the unvaccinated.

The lesson is that vaccination totally works and is our best path out of this crisis. And we have a narrow window in which to enact this process. So we shouldn't try to mess this up. Right. So once it's dominant, we might need to enact some more potentially strict measures to control it. But it's not dominant yet here, so we have time. Okay. And I want to get to those potential measures in a minute. But first, you mentioned that vaccines work against this variant. What about one dose of vaccine, which roughly 70% of people in Canada over 12 have right now? Does that give you enough protection? It gives you some protection. So we think that the Pfizer vaccine gives about 33% efficacy

against this variant. Two doses gives you close to 90%. Two doses of AstraZeneca gives you about 60%. And that number is going to increase as more data comes in from the UK. But I liken it to, if you're out in the rain, you could wear a raincoat and an umbrella or an umbrella. So one dose would be the raincoat, two doses would be the umbrella and the raincoat. And if it's really pouring, you kind of need both to keep your whole body dry. And what you don't want is to wear a baseball cap during a complete downpour. So the Delta variant represents a potentially torrential rainfall. So the strategy has to be get two doses into as many people as we can as quickly as we can. And then I think we're fine. And of course, this is why Ontario is moving to sort of pump vaccines into those hotspots again,

hey, Toronto, the greater Toronto area. The people who have one dose and contract this variant, do they get less sick because they have the one dose? That's a tough question. I don't really know the answer to that. I would suspect that they do. But as we know, we have hospitalization data, and amongst those hospitalized, a certain proportion have had one dose. So it isn't guaranteed to keep you out of the hospital, but it does offer some protection. As a result, it's not advisable to be lifting restrictions willy-nilly and to be living our lives to the fullest that we can. While we just have one dose, we have to take our time and be a little cognizant of the risks. Okay, so I wonder if I could put some specific scenarios to you, because most people have had one dose and maybe older people now have had two doses or have had the opportunity or having the opportunity to get two doses. And instead of sort of a do's and don'ts list here,

I wonder if we could talk more in terms of risk, right, just to give people a better understanding of the factors that they should be weighing. And here's one hypothetical situation. So I live in Toronto and I'm going to drive to spend the weekend at my parents' house, who let's say live in Montreal. And I've had one shot and they've had one shot. And let's say they're in their 60s. And my main concern here is I don't want them to get sick. So what kinds of questions do you think I should be considering before I take that risk and considering some of what we talked about already? Yeah, excellent question. And it's a scenario that a lot of people ask me all the time. This is about layering probabilities over top of each other. So the probability of one

dose giving you protection, for example, the probability of two doses giving them protection, the probability of being exposed to the virus in the first place. So where you live in Toronto is a high risk area. Montreal is a medium risk area. So the probability of acquiring infection has to be considered. Then there is the actions and the activities and the behaviors and lifestyles that you have and that your parents have. And that will heighten the likelihood of being exposed. Remember, vaccination is not a bulletproof vest. It's probably a raincoat or an umbrella, which has the potential of getting wet still. And your probability of a vaccine failure is related to things like how prevalent the disease is where you are and how likely you are to

encounter the disease. The more likely you are to encounter it, the more likely the vaccine will have an opportunity to fail. That's an imprecise way of phrasing it, but I think that works for this analogy. So if you're coming from a hot zone area, you have a higher risk of becoming infected and perhaps even asymptomatically and passing on to somebody. If you are engaging in a variety of activities throughout the week, going to coffee shops, meeting strangers, each of those encounters increases your risk of acquiring the disease and becoming asymptomatically infectious. So if you are a hermit living in a place where there is no disease

and you take a hermetically sealed tube to your parents' house, then your risk of... Like you're good, yeah. Yeah, it's fine. But anything beyond that ratchets up the risk measurably. You know, talking about the fact that you could get it and it won't be as severe, especially if you've already had one, but particularly two doses, you know, young people who want to hang out with their friends. So let's say you've got five friends, they're in their late 20s or early 30s, they're all healthy, they all have one dose.

So how should these people be thinking, though, about their risk of transmitting it to other more vulnerable people out there? So first, I want to point out that in India, what they're seeing with this variant is that entire families are coming into the hospital, whereas before it was one individual. That means that the risk of household transmission is higher with this variant. So the potential for an individual to give it to their loved ones is higher. So you should think about that this is not about you. It's about the community and your loved ones. Earlier on, I saw that a UK scientist had tweeted out that he was measuring exponential growth of the Delta variant in the UK. And the first tweet

in response was from a UK citizen saying, what do I care? I've had my two doses. And that to me underlines the issue here. This is not about individual risk or protecting of the self. This is about how much you can protect other people and contribute to the population immunity endgame. So what young people need to think about is this isn't about your rights and needs to socialize, even though those are real. It's about mitigating as much risk as you can to prevent passing on disease to other people. So I wonder if I could push back on that a little bit and sort of take up the cause of that, that tweeter, right? So, so, look, at this point in the game, in this country, the most vulnerable people, older people, people with underlying conditions, have had the opportunity to get two shots, or are just sort of on the cusp, right? the opportunity to get two shots or are just sort of on the cusp, right? And so why is it the responsibility of younger people, of other people who maybe aren't carrying as much risk to mitigate their

behavior for people who have chosen to not avail themselves of those resources, of those vaccines that are pretty, pretty available at this point? That's a heavy question. And there are two ways to approach it. First is the pure ethics of it, that, hey, we should always be considering the health of other people, even if we don't think they might deserve it. The second is, there's a selfish reason, is if we keep other people from getting sick, guess what? Our healthcare system doesn't collapse. Guess what?

We don't have to enact any more restrictions. Guess what? Our economy improves. We can take that trip to Greece that you've been planning for the last few months. So you get all the marshmallows if you protect each other. It's not really altruism anymore, is it? It's a kind of selfishness that can appear altruistic, which is the best kind of altruism. Selfish altruism.

Exactly. I like it. Everybody wins. So those are the two facts I would take. I'll see you next time. empowering Canada's entrepreneurs through angel investment and industry connections. No, their own household income. That's not a typo. 50%. That's because money is confusing. In my new book and podcast, Money for Couples, I help you and your partner create a financial vision together. To listen to this podcast, just search for Money for Couples.

How do you think the provinces should be thinking of this new variant right now? So BC is moving to open movie theaters on Tuesday. Alberta is making preparations for the Calgary Stampede in July. And patios have opened in Toronto, though I should say the schools aren't opening in Ontario. And what kind of considerations do you think leadership should be taking right now? Do you see anybody moving in the wrong direction? That's a loaded question. But in general, outdoor activities are almost completely safe. Nothing's completely safe.

But anything outdoors drastically diminishes the risk, which is great. But this desire to open things up rapidly is underpinned by an expectation of the vaccine to be this messianic technology that is perfect. The vaccine is fantastic, but it's not perfect. And it only works, it only achieves the end goal of getting rid of the pandemic if we layer on top of it other mitigation strategies that we lift strategically and slowly. If we lift those mitigation tools too early, vaccination won't do its job well. As my colleagues are fond of saying, we can't vaccinate our way out of this fully. We need

the other tools. So I encourage our leaders to consider that while vaccination will be the tool that ends this thing once and for all, it can't do it on its own. We have to allow the other tools to enact their effect before vaccination can take hold. And just picking up on maybe the most loaded part of that question, do you see any provinces right now where you're particularly concerned? Do you think they're moving too fast? Well, Alberta concerns me a little bit. I think there is a narrative of an over-reliance on vaccination, echoing what I've heard in some American states. I've had my two doses, everything should be fine. No, everything's only fine when you've got the incidence rate down low

so that those two doses can be well relied upon. I think Ontario, remarkably, is doing some very rational things lately. I say remarkably because I've questioned some choices made throughout the past year, but lately they've been quite rational choices. So I'm feeling weirdly optimistic as a whole when I look at the country. And just picking up on Ontario, do you agree with the decision to keep the schools closed? I know Doug Ford literally cited the Delta variant. Yes, I do agree with it. And we can interpret the data in different ways. But ultimately, to me, it's a risk versus reward scenario. The reward is opening schools for two,

three, maybe four weeks. I'm not sure what educational outcomes you get from that. Yes, there are some positive mental health outcomes and some respite for parents and so forth, which are not small things or important things. but you risk losing the entire game. I've likened the risk to betting your mortgage on winning $100. So that might make sense if the odds were really in your favor. I'm not so sure the odds were sufficiently stacked in our favor to make that bet. So I support the decision to close schools. This weekend, the G7 made a pledge to share at least a billion vaccine shots to struggling countries with a goal of providing two billion eventually. Canada's contributing 100 million doses. During a news conference

following the conclusion of the summit in England's Cornwall, Johnson said the pledge was in response to a request by him. Doses either directly or through funding to COVAX to the world's poorest countries, which is another big step towards vaccinating the world. In the context of this new variant, what do you think of that announcement? Is it enough? Because of course we know that to beat this thing, we have to beat it globally. Yeah, there's a lot to unpack there. First is great, great that we're donating one or two billion doses. However, we need five or six billion doses, if not more. We need two doses in every person in the world, pretty much. And most countries can't afford it. Distributing the doses, maybe even assistance in getting people to shove jabs into people's arms, transportation, storage, all that kind of stuff. So it's not just about getting the actual pharmaceuticals to the destination.

There's more involved there. Then there's the idea that really what we care about here are the mRNA vaccines. I know it's not fashionable to be ranking vaccines right now, but current data does suggest the mRNA vaccines are the most effective against the Delta variant. Now, new data might come out soon suggesting that AstraZeneca has been underestimated throughout all this, and that might be the case. But many of the world's poorest countries are relying upon these other vaccines, the non-mRNA ones. It's difficult to ramp up production of this new high-tech vaccine. So there needs to be a commitment, I think, for greater production, not just in sharing. It's a great first step. I'll add as well that some of that pledge of one to two billion doses

are previous pledges that have been repackaged. So I'm not sure how much of this is actually new. So we've got to keep leaders' feet to the fire to make sure that they understand that this is not altruism again. This is selfishness. We get back to a global economic normal if the entire world goes back to normal. This only happens if we stifle this disease in Brazil, in India, and in every place where it is now boiling over. It's entirely for our own benefit. And of course, if this thing is rampaging in other countries in the world, we run the risk of an even more dangerous variant that perhaps is very much resistant to vaccines.

That is 100% correct. These variants emerge in places where transmission is occurring at a high rate because it's an evolutionary laboratory for the virus. It tries out new things until it finds something that bypasses our defenses. What we don't want is for the virus to discover a variation that bypasses our vaccines. Currently, that's not happening, but it will eventually happen if we give it time to do so. So two things have to happen. We have to vaccinate rapidly at scale, and we have to be ready possibly to accept booster shots that have been modified to account for new variants. We will win the arms race against this virus, but it'd be better if we didn't have to fight that arms race. Okay. Ray, thank you for this. I have definitely had more depressing

conversations about COVID, so I appreciate it very much. My pleasure. All right, that is all for today. And I just wanted to note that I think it's quite possible that my one-year-old made a few appearances in that podcast. So my apologies for that. But thank you so much for listening. And we'll talk to you tomorrow. For more CBC Podcasts, go to cbc.ca slash podcasts.