Monday, November 29, 2021 | Category: Eduvation Insider
Or if you prefer, you can recognize Chocolates, Lemon Cream Pie, Square Dancing, or simply Throwing Out Your Leftovers – perhaps more appropriate if you held a big gathering for American Thanksgiving on Thursday. But somehow it seems more appropriate to note that Saturday was “Pins and Needles Day,” because that’s where we are now…
Just a week ago, I was starting to feel uncharacteristic optimism about the path of the pandemic, the advance of vaccination and the return to campus for January. Clearly we were all going to need booster shots soon, and likely annual vaccines, but life seemed to be getting back on its feet. January seemed a bit overly optimistic to me, but only by a few months. I was still emphasizing that CdnPSEs should have back-up plans for academic continuity –whether due to potential regional “fifth waves” of the pandemic, or simply to cope with extreme weather conditions.
I was a little surprised to see how excitedly Colleges Ontario was promoting an “in-person” Higher Education Summit this week in Toronto, but admittedly last Tuesday I was starting to discuss (very tentatively) some possible in-person events for May or June 2022.
It was as though I had forgotten the relentless pessimism and excess caution that had served me so well in tracking the trajectory of this pandemic for the past 20 months. Since the Delta variant, I’ve tracked so many variants of interest and concern that ultimately proved false alarms, I was getting lulled into a false sense of security.
Then came Black Friday, in oh, SO many ways…
Since the Delta variant erupted on the scene 6 months ago, driving a fourth wave of the pandemic and a third round of vaccination shots, epidemiologists have assured us that we should expect ongoing mutations to produce endless new COVID19 variants, hitting the healthcare system, economic sectors, and society like minor aftershocks. Like Californians living near the San Andreas Fault, we knew “the Big One” could come any day, but as the WHO dismissed variant after variant as minimal threats, we started to anticipate a return to normal for Christmas and the new year.
(Then again, I DID title my Pandemic Précis last week “the Calm Before the Storm.”)
South African Spike
I mentioned last week that Africa has been miraculously spared the worst of Delta infections, despite having just 6% of its population vaccinated against COVID19. But I also mentioned that South Africa has been hit hard, and that doctors in Zimbabwe were sounding the alarm last week about the risks of complacency. Later last week, the number of confirmed daily cases in SA spiked exponentially, from ~200 a day to 2,465 on Thursday, 2,828 on Friday, and 3,200 on Saturday – and particularly infecting young people in their 20s and 30s (who are largely unvaxxed). Initially, it looked like a cluster infection among university students in Pretoria, but it quickly became thousands of cases across Pretoria and Johannesburg. AP
“Complacency is what is going to destroy us because we may be caught unaware.” – Johannes Marisa, president, Medical and Dental Private Practitioners of Zimbabwe Association
“The Worst Yet”
Just as Americans were sitting down to Thanksgiving turkey last Thursday, scientists in South Africa announced the detection of a new COVID19 variant responsible for about 90% of their new cases. (It was actually detected on Tuesday, in samples taken a week previous, and the earliest sample was from Nov 9.) B.1.1.529 is not descended from Beta or Delta, but is a new lineage of COVID19 with ~50 mutations, 32 of them on the spike protein, giving it a “really awful spike mutation profile,” in the words of one UK virologist. (That’s twice the number of spike protein mutations as the Delta variant. B.1.1.529 theoretically appears to be both more transmissible and more capable of evading immunity, although it will take weeks for scientists to determine just how much more. It is also unclear whether it will outcompete the Delta variant in the wild.) South African physicians are reporting an “exponential rise” of cases, an alarming reproduction rate of 2.0, and a higher rate of breakthrough infections among the fully vaxxed. One uWarwick virologist said this is “the most heavily mutated version of the virus we have seen,” with potentially worrying changes never before seen in a single strain. Epidemiologist Eric Feigl-Ding says the new variant is “possibly ~500% more competitively infectious” and is rapidly displacing Delta in South Africa (see graphs above and below). One uOttawa virologist says “we know for a fact that this variant will be more difficult to neutralize.” The assumption is that some degree of “immune pressure” forced the virus to evolve in an immunocompromised patient with a chronic infection – and in South Africa, many people with untreated HIV could be in that pool. Globe & Mail | Washington Post | AP | The Conversation | New Scientist
“It’s an astonishing number of mutations.” – Jeffrey Joy, genomics research scientist, UBC
“What we do know is there’s a significant number of mutations, perhaps double the number of mutations that we have seen in the Delta variant. And that would suggest that it may well be more transmissible and the current vaccines that we have may well be less effective.” – Sajid Javid, UK health secretary
“At least from a speculative point of view we have some optimism that the vaccine should still work against a new variant for serious disease but really we need to wait several weeks to have that confirmed.” – Andrew Pollard, director, Oxford Vaccine Group
Past Nu and Xi to Omicron
On Friday, just one day after the strain was identified, the WHO designated it as the 5th COVID19 variant of concern, christening it “Omicron.” (Skipping over Greek letters “Nu” and “Xi” to avoid confusion with “new” and offense to Chinese leader Xi Jinping – but what about poor Omicron Networking or Omicron Development?) Considering how many variant strains the WHO has monitored for months without ever designating them VoCs, or even VoIs, this certainly appears to be a signal of potential risk. “We need to learn as much as soon as possible. We know precious little.” Global
“By the time you detect one variant, another is already circulating under the radar somewhere… We will be chasing variants endlessly.” – Kizzmekia Corbett, viral immunologist, Chan School of Public Health, Harvard
Stock markets immediately reacted to news of Omicron with panic: the Dow Jones industrial average plummeted more than 1,000 points, the S&P500 fell 107 points, and the Nasdaq 354 points – even on a holiday-shortened trading day. Not surprisingly, the price of oil fell by 13%, and United Airlines stock fell 9.6%. (“Investors are likely to shoot first and ask questions later.”) Even Bitcoin fell 8.4% – while shares in Zoom, Peloton and Pfizer rose by about 6%. New York State declared a state of emergency, sure that Omicron would be there soon. By noon Friday, countries around the world (including Canada) were announcing travel bans or quarantine requirements on flights or passengers coming through southern Africa, and updating travel advisories against African countries. Israeli PM Naftali Bennett said “we are currently on the verge of a state of emergency. Our main principle is to act fast, strong, and now.” British health secretary Sajid Javid said “we must move quickly and at the earliest possible moment.” The World Trade Organization postponed next week’s meeting of ministers in Geneva “indefinitely.” (One Calgary emergency room physician thinks we should clamp down on inter-provincial travel in Canada, too.) By Sunday, Israel was going a step further and barred entry by all foreigners – as did Morocco, at least by air. The US plans to ban travel from southern Africa beginning today.
In mere hours last week, global confidence in travel, tourism, hospitality and – yes – international student mobility took a beating. We won’t know for several weeks whether this was an under- or over-reaction, but clearly we’re still living in a time of pandemic turbulence and heightened global volatility.
As NIAID director Anthony Fauci observed in the journal Cell more than a year ago, “we have entered a pandemic era” in which novel viruses will rapidly spread across the globe, thanks to habitat destruction, climate refugees and international travel. Even though Omicron was identified within just 14 days in South Africa, it likely had time to spread around the planet before we had even heard of it…
Spreading Like Wildfire
Not only was Omicron spreading quickly across South Africa, but by Friday cases had been identified in Botswana, Belgium, and Israel. Hong Kong reported 2 cases – including a traveller from Canada who caught it while in a quarantine hotel there. Saturday morning, Britain confirmed its first 2 travel-related cases in Nottingham and Brentwood. 600 travellers from South Africa arrived in the Netherlands just minutes after the government banned flights, and 61 tested positive for COVID19. By Sunday, the Netherlands had confirmed 13 as cases of Omicron, and Australia had identified 2, in fully-vaxxed travellers from southern Africa. (260 otherpeople aboard their flight have been ordered to quarantine as close contacts.) Italy had confirmed at least one case of Omicron, Germany 3, Denmark 2, France 8, and Austria one.
(Sigh. I’ve revised the paragraph above so many times that it is unlikely to be up-to-date by the time you read it. This is a rapidly-evolving situation.)
Omicron in Canada
Sure enough, just as I was hoping to put this issue “to bed” last night, Ontario reported it had confirmed Canada’s first 2 cases of Omicron in Ottawa, in 2 travellers recently returned from Nigeria. The PHO has them in isolation, and is tracing their contacts. (Start with everybody on their flight, please!) CTV | CBC | Global
“The cat’s already out of the bag, so to speak.” – Nicole Errett, public health prof, uWashington
Viruses Ignore Borders
The WHO continues to emphasize that travel bans are ineffective, provide only a false sense of security, and only serve to punish countries for transparency in reporting new variants. Sadly, the reality is that the Omicron variant is likely already circulating worldwide, and imposing a travel ban on a few selected countries will notprevent its spread. (“If we shut the door now, it’s going to be probably too late,” in the words of one Hong Kong epidemiologist.) Canada’s chief PHO, Theresa Tam, said Friday she “wouldn’t be surprised” to see cases surface in Canada shortly. Vaccination, masking, ventilation and social distancing (but probably not Plexiglas barriers) remain far more effective ways to prevent transmission of this or any airborne virus. (Even British PM Boris Johnson has reinstated some quarantine and mask requirements.)
Unfortunately, the fact that Omicron has surfaced just as 48M Americans stirred the viral stew by travelling for Thanksgiving, and millions more crowded stores for Black Friday sales, means the impact could be significantly worse.
“It’s akin to playing goalie and having 30 people shoot pucks on you at the same time. You’re just not going to keep this out.” – Sumon Chakrabarti, infectious diseases physician, Trillium Health Partners
The emergence of new variants in under-vaccinated countries, whether India, Brazil, or South Africa, only underscores the importance of a global vaccination strategy to combat vaccine “hoarding.” Getting a few wealthy countries to 90% vaxxed won’t stop COVID19 from evolving elsewhere. “Until we vaccinate enough people, we’re going to have this happen over and over again.” The G20 have already monopolized 89% of all vaccines globally. The WHO has been urging us to forgo booster shots in order to get first doses to vaccine deserts like Africa, and if we had only listened sooner, Omicron might have been postponed or even avoided entirely. As former UK PM Gordon Brown wrote this weekend, the world urgently needs “a pandemic non-proliferation treaty.” Washington Post
“Our failure to put vaccines into the arms of people in the developing world is now coming back to haunt us. We were forewarned – and yet here we are.” – Gordon Brown, former prime minister of Britain
Now, we may need to retool our vaccine defences (although it will take several weeks to know for sure.) AstraZeneca said Friday it was testing Omicron’s “real-world” impact on its Vaxzevria vaccine and AZD7442 antibody cocktail in Botswana, and remained “hopeful.” BioNTech says it expects more data within 2 weeks to determine whether the Pfizer vaccine will need to be “reworked.” (If necessary, they could ship a new tailor-made mRNA vaccine in ~100 days – so likely around March.) Moderna says it is working on a booster tailored to the new variant, while also testing a higher dose of its existing booster. (Versions of the Pfizer vaccine targeted to Alpha and Delta are still in clinical trials.)
While the mRNA technology has vastly accelerated vaccine development cycles, the emergence of a truly immune-escape variant of COVID19 would set us back months in reopening.
So, aside from the rise of Omicron, what did the past week look like for the pandemic? Things were tense in Europe and parts of North America, kids were getting vaxxed, and Western reported its first residence outbreak this year…
Europe Already Critical
Europe has been the pandemic’s epicentre for several weeks now, and the WHO warned the region could see another 700,000 deaths by spring, thanks to a combination of vaccine hesitancy and waning immunity. (Somewhat self-interestedly, AstraZeneca CEO Pascal Soriot says the UK’s advantage over Europe could be attributed to better uptake of his company’s vaccine, as opposed to the mRNA shots.) Although the UK was hit hard by the Delta variant back in the summer, European countries are experiencing it now, resulting in lockdowns or reimposed restrictions in Austria, Germany, the Netherlands, and Belgium. Switzerland, facing a fivefold increase in cases this month, held a referendum this weekend in which voters appeared to support vaccine passports. Slovakia imposed a 2-week lockdown on Thursday, as hospitals strained amid the world’s highest COVID19 incidence rate. Czech Republic president Milos Zeman was taken to hospital for COVID19 treatment, declared a 30-day state of emergency, and is considering making vaccination mandatory for at-risk groups. The country reported 27,717 new cases on Thursday alone, and has infection rates 4x the rest of Europe.
Midwest US is Slammed
In the past week, US cases of COVID19 have surged 18%, hospitalizations 6%, and deaths 9%. The country is averaging some 100,000 new cases every day. Hospitals in Michigan are being overwhelmed by an “almost unmanageable” flood of unvaxxed cases as the state reached all-time highs and requested military assistance. (The only reason Spectrum Health was reluctant to declare “code red” status is that they anticipate even worseto come, and “don’t have a darker colour.”) To make things worse, uMichigan has been grappling with an outbreak of 500+ flu cases – and nonetheless (sigh), students are rallying in protest of vaccine mandates. COVID19 cases are also up significantly in New Mexico and North Dakota – and even in highly-vaxxed stateslike Minnesota, New Hampshire and Maine. “When you have a virus as transmissible as Delta, in the context of waning immunity, that dynamic is going to negatively impact even the vaccinated people.”
Rising Numbers in Canada
As winter sets in, restrictions are lifting and immunity starts to wane, many regions of Canada are starting to experience rising case counts of COVID19. Quebec’s case counts have been steadily rising this week, and its state of emergency will remain in place until 2022. Ontario has been logging more cases, and the CMOH forecasts that case counts will continue to rise until spring: “We never declared the fourth wave over. This is simply a continuance.” (I don’t know – it sure looks like a fifth wave in the graph above.)
“We never declared the fourth wave over. This is simply a continuance.” – Keiran Moore, Ontario Chief Medical Office of Health
Saskatchewan Holds Tight
On Thursday, Saskatchewan premier Scott Moe announced he was extending current pandemic health restrictions (including mandatory masks indoors and in schools, and proof of vaccination requirements) at least 2 more months, until Jan 31, to help avoid a potential post-holiday fifth wave. (And Moe indicated they were likely to be extended again at that time. CMOH Saquib Shahab has suggested the mandates should continue until spring.) Pressure on SK hospitals has plateaued, but many epidemiologists worry about the impact of waning immunity in the winter months. Business groups and opposition politicians gave the move cautious support. CTV | Globe & Mail | Saskatoon Star-Phoenix
Changes for Canada
As Parliament resumed in Ottawa last week, and Conservative politicians challenged the vax mandate on the House of Commons, Ottawa confirmed a hybrid sitting format until at least June, and introduced new legislation to make it a criminal offence to intimidate patients or healthcare workers. The next challenge for Health Canada and NACI will be to balance third dose boosters for the general population with vaccine equity for other countries, in the face of rising anxiety about the Delta and Omicron variants: “at 8 months, is a vaccine effectiveness of 70-something per cent good enough? Or is that going to open the door to disaster?”
Rolling Up Little Sleeves
Many parents felt a sense of relief last week as pediatric COVID19 vaccinations rolled out for children aged 5-11 across Canada, at immunization clinics in Alberta, Saskatchewan, Manitoba, Ontario, Quebec, New Brunswickand PEI, at pharmacies in Nova Scotia, and in schools across Newfoundland & Labrador (and eventually also Ontario, Quebec, Manitoba and Saskatchewan). Parents in British Columbia have been booking appointments for their children to start this week. Shots for children will begin in the NWT shortly, and in the Yukon Dec 6. An SFU mathematician calculates that, if 87% of 5-11-year-olds get vaxxed, Canada’s overall vaccination rate will reach almost 85%. (Although many epidemiologists say we need to achieve 90-95% for effective herd immunity against the Delta variant.) Pfizer is already running clinical trials for infants from 6 months to 5 years of age, and Moderna is recruiting children for a similar study. A baby/toddler shot could be approved by Health Canada early in 2022.
New Outbreak at Western
Longtime readers will recall that Western U experienced outbreaks in at least 8 of its campus residences during the 2020-21 academic year, with more than 377 cases logged in its community (by my count – not to mention 170 in adjacent University Hospital). That experience doubtless contributed to Western’s somewhat controversial decision to mandate full vaccination in its residences back in May, long before it was the CdnPSE trend. And yet, nonetheless, just as the Fall 2021 term draws to a close, Western announced Saturday another residence hall outbreak, with 5 students in Saugeen-Maitland Hall testing positive for COVID19 (so far… SMH holds 1,250 beds). There is “no evidence of classroom transmission,” and the students are self-isolating. The local PHO says these students were vaccinated. Western News | CBC | London Free Press | Global | CTV
Thanks to the emergence of Omicron, it’s suddenly too early to forecast what the pandemic will look like in the next few weeks, or by January – but that in itself is a MAJOR change from the relative certainty we all had a week ago!
This Could Blow Over…
Until we have more certainty about Omicron’s R0 rate and its impact on the effectiveness of existing vaccines, any public health reactions are just “out of an abundance of caution.” In the words of one infectious disease specialist, “I don’t want to discount this, but I don’t want to sensationalize it, either.” The Omicron variant could all blow over by Christmas and be entirely forgotten by New Year’s, much like the Beta and Gamma variants did…
Or Change Everything
But as we sit here on pins and needles, we also have to consider the very real possibility that we may have just witnessed the start of a major new wave of the pandemic – in which case, plans for in-person conferences, convocations, or the return to campus in January could at best be frustrated and complicated by border closures and new PHO restrictions, and at worst could have to be completed reversed. Over the next few weeks, scientists will measure Omicron’s transmissibility, infectiousness, virulence and capacity for immune escape. By Christmas (or at least Epiphany), the wise men may bring us some answers on this new variant from the East.
Optics and Politics
Some of the key decisions that PHOs will make in the coming days – whether to close borders, reimpose quarantine requirements, close schools, or enforce physical distancing or capacity limits again – will hinge on that science, but as always much will be determined by politics. And campus leaders will need to be conscious of the impact of their own decisions on the confidence of staff and faculty, and perceptions of their institution from the surrounding community. The optics won’t be good if our campuses incubate outbreaks of the Omicron variant in January. (As it is, this week’s crisis first appeared to be the result of student parties at Tshwane U of Technology in Pretoria.)
So, just as I was thinking I could drop my weekly “Pandemic Précis,” and enter hibernation until January, we find ourselves in a rapidly-changing, urgent phase of the pandemic once again. (As the Washington Posteditorial board put it Friday: “the pandemic is the unwelcome guest who won’t leave.”) As always, I’ll do my best to keep you informed. The next few weeks may be crucial in shaping Winter term 2022 for CdnPSE. (More on that next time!)
Although entirely unintentional, a slick new campaign from Royal Roads U echoes the theme of today’s issue, in a sense…
Are You Ready?
Royal Roads U is in field with its latest “Boldly Different” campaign, running in digital, social, print and outdoor through March 2022. A series of :15-sec videos feature bold, punchy graphics and diverse students leaping into new careers, opening doors to their future, confronting their future selves in a mirror, andamplifying their ambition. Instead of asking prospective students to apply, RRU challenges them with a series of bold questions: “Are you ready to meet your future? …to reinvent yourself? …to elevate your education?” Instagram polls ask viewers whether they want to “change my career” or “change the world.” Explains RRU, “this year’s campaign carries the rallying tone of the previous campaign and pairs it with compelling visual twists on transformation and empowerment.” YouTube | Stimulant Online | RRU Campaign Page
Phew! As always, thanks for reading this far – and my sincere apologies for starting off your week with an in-depth look at what could be pretty bleak news!
Clearly, we all need to stay vigilant and flexible, as pandemic uncertainty continues. Tomorrow, I’ll take another look at CdnPSE announcements for the Winter term, and consider how the evolving Omicron story might impact those plans.
Meanwhile, as always, stay safe and be well!
All contents copyright © 2014 Eduvation Inc. All rights reserved.