Canada is likely at the start of a new wave of COVID-19, but how bad it will be is unknown, some health experts say.
The turn comes after months of low transmission of the virus, which continues to mutate and has recently spawned two variants — EG.5, a subvariant of Omicron, and BA.2.86 — that have captured the attention of scientists.
“We’re starting to see an uptick in cases after a pretty long decline. We saw really an impressive drop in the number of infections that started right at the end of 2022 and continued to all the way to the middle of this summer,” Dr. Fahad Razak, a professor at the University of Toronto and internal medicine physician at St. Michael’s Hospital, told Global News Wednesday.
“Over the last few weeks, we’ve started to see that rise again … It’s that expected rise. I think nothing of that is surprising to any of us that, after a period of decline as the virus continues to mutate, you’ll have a period where you start to have that increase again.”
Dr. Jesse Papenburg, a pediatric infectious disease specialist at the Montreal Children’s Hospital of the McGill University Health Centre, shared similar sentiments with Global News earlier this month.
“I think most people expect that there will be a certain amount of seasonality to COVID-19, and we do expect that the case counts will rise in the fall and winter,” he said.
“How much of a surge it will be remains to be seen.”
The latest data on COVID-19 in Canada
With two new COVID-19 lineages emerging just before the fall — a season when respiratory viruses thrive — Razak is warning Canadians to stay vigilant.
According to latest federal wastewater data, 10 regions reported an increase in COVID-19 activity. The latest data was updated Aug. 22 and contained information up to and including Aug. 15.
Regions that reported increases include Bridgewater, N.S., St. John’s, N.L. and Edmonton, Alta. At least nine regions reported decreases, while 20 sites showed no change in data.
In terms of reported new infections, Canada logged 2,071 in the week of Aug. 6 to 12. However, case counts remain underestimated due to changes in reporting since at least December 2021, Ottawa states.
Scientists, meanwhile, continue to closely monitor the virus and two of its variants, EG.5, a subvariant of Omicron, and BA.2.86, a mutation that so far appears distinct from its likely parents, including the currently-dominant XBB.1.5 variant of Omicron, which itself was much more transmissible and deadly than the original strain of SARS-CoV-2.
There is much to learn about both variants, but the World Health Organization has labelled E.G5 as a “variant of interest” and BA.2.86 a “variant under monitoring.”
“Public Health Agency of Canada scientists, along with national and international experts, are actively monitoring and evaluating BA.2.86 lineages,” a Health Canada spokesperson told Global News in a statement Friday.
As of Friday, “there have been no detections of the BA.2.86 lineage in Canada,” spokesperson Anna Maddison said.
Canada’s infection increase coincides with an erosion in immune protection and cooler weather, where more Canadians will be inside — an environment prime for respiratory viruses.
“My expectation is that after seeing a pretty long period of declining COVID numbers, we’ll start to see that uptick now heading into the fall and winter,” Razak said.
“We are likely at the start of a new wave here. … how big it will be remains unknown.”
COVID-19 hospitalizations rose last year: CIHI
Despite an overall slowing of COVID activity over the past year, new data highlights the impact the virus continues to have on hospitals.
The Canadian Institute for Health Information (CIHI) released data Wednesday showing COVID-19 hospitalizations increased by 19 per cent between April 2022 to March 2023. During that time frame, there were more than 120,000 hospital stays, an increase from 101,000 the previous year.
Meanwhile, COVID-19 emergency department visits were down. Emergency departments in Canada logged 222,000 COVID-19 visits between April 2022 to March 2023, down from 262,000 visits the year prior. CIHI noted its data excludes Quebec.
“As we move out of the pandemic, COVID-19 continues to impact hospitals and EDs across the country,” said Juliana Wu, director of acute and ambulatory care information services with CIHI.
CIHI said of the 2022-23 COVID-19 hospitalizations, most patients were older with the median age being 75, compared with 63 the previous year.
Ninety per cent of emergency visits were completed within 25 hours, an increase from 15 hours the year before. The majority of patients (69 per cent) who went to emergency were discharged home, while 26 per cent were admitted to hospital.
More than half (62 per cent) of patients admitted to hospital were discharged home, while 10 per cent died in the facility. The average length of stay in hospital increased to 20 days from 13 the previous year, CIHI noted.
Thirteen per cent of hospital stays included an ICU admission. Among those patients with ICU stays, 39 per cent received ventilation and 23 per cent died in the facility.
“COVID remains a major issue still in hospitals,” Razak said.
“That severe respiratory COVID infection phase, we’re really not seeing that very much anymore, but COVID infecting people and causing problems still as exacerbating illnesses, causing people to be sick enough that they end up in hospital, that it still is occurring.”
COVID health tips for fall
In addition to cooler weather, more Canadians will be heading indoors as they to return to work in offices for the first time in three years.
Statistics Canada released a report Tuesday that showed that nearly 16 million Canadians — or four in five employees — commuted to work in May. This represents a 4.8 per cent increase compared with last year and a 26.2 per cent jump from 2021.
Some institutions are already taking measures to stop the spread of COVID as cases emerge.
Morris Brown College, a private school in Atlanta, Ga., said in an Instagram post it was reinstating its mask mandate due to reports of positive cases.
Razak is advising Canadians to stay up-to-date on their vaccinations and to mask up in high-risk settings. He also recommended better air quality in buildings.
“We want society to move away from the severe disruptions we experienced the last few years and get back to all of those things we value,” he said.
In its latest COVID-19 vaccination guidance published last month, Canada’s National Advisory Committee on Immunization (NACI) recommended all Canadians aged five years and up get a COVID-19 booster in the fall if it has been at least six months since their last vaccine dose or infection, whichever is later.
A bivalent vaccine that targets Omicron is currently available to Canadians, but NACI anticipates that the new vaccine formulations could be available this fall.
While an Omicron vaccine is ideal, any booster that is available is going to be effective at reducing infection, Dr. Prabhat Jha, an epidemiologist at Unity Health Toronto, told Global News earlier this month.
— With files from Global News’ Saba Aziz and Sean Boynton
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