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Of vaccines and variants – doctors explain the COVID-19 pandemic minefield

By Sharon Harrison
While COVID-19 cases rise in the province and in the region, some 70 participants tuned in to an informative online talk by two doctors about vaccines and variants.

The Bay of Quinte Green Party of Ontario welcomed Dr. Gerald Evans and Dr. Alan Bernstein OC to its monthly virtual speaker series, moderated by County resident John Hirsch.

Dr. Alan Bernstein

Dr. Bernstein gave opening comments and a short presentation about Canada’s vaccines, followed by a longer presentation by Dr. Evans, on the infection-related aspects of COVID-19 and how it has been dealt with from a public health and safety perspective.

Bernstein, a part-time County resident, is a member of Canada’s COVID-19 Vaccine Task Force, and is President and CEO of the Canadian Institute for Advanced Research (CIFAR) and has spent a career in virus and vaccine research.

Evans is the Medical Director of Infection Prevention and Control at Kingston Health Sciences, as well as a member of the Ontario Science Table, Chair of Infectious Diseases at Kingston Health Sciences Centre and Providence Care Hospital, Affiliate Scientist at the Institute for Clinical Evaluation Sciences at Queen’s University, and Editor-in-Chief of the Journal of the Association of Microbiology and Infectious Disease Canada.

Bernstein noted that world-wide there have been more than 120 million cases of COVID-19 in the last year, with close to three million deaths.

“The other figure that is also quite striking, as of a week ago, there have been 363,391,238 vaccines administered around the world, and those vaccines have been mostly administered in North America and in western Europe, and not really around the world – which is a problem.”

“It is a remarkable number where we not only have vaccines in one year, but we already have 400 million vaccinated.”

He gave an overview of what vaccines are and how they work.

“Vaccines are designed to reduce the risk of infection and also transmission of the virus or bacteria by training our immune system to recognize and to fight any incoming pathogen, such as a virus or some bacteria,” explained Bernstein.

“The best vaccines are safe and will safely deliver an immunogen which is a specific type of antigen, which is what your immune system recognizes as being foreign, and so it makes an immune response, which is typically antibodies and that trains the immune system to recognize that pathogen, and to kill it or neutralize it.”

The history of vaccines goes back almost 200 years when Edward Jenner discovered that milkmaids in England didn’t get smallpox when they were milking cows.

“They were milking cows that were exposed to the cowpox virus, which is basically serving as a vaccine, because the cowpox virus and the human smallpox virus are very similar, so they were essentially being immunized against smallpox.”

Bernstein noted that the word ‘vaccine’ comes from ‘vacca’ from the Latin for cow from the 1700s.

He notes smallpox historically has been the world’s largest killer of humanity as hundreds of millions of people died.

“This year, nobody will die of smallpox; last year, nobody died of smallpox, and next year, nobody will die of smallpox because it has been eradicated because we have very effective vaccines that have eliminated smallpox from the planet,” explains Bernstein. “That’s how powerful vaccines are at defending humanity against this age-old battle of pathogens.”

Bernstein went on to say how vaccines have changed since the 1950s, where more sophisticated and safer technologies now exist.

“You are never exposed to the whole virus now and you are in no danger of getting COVID-19 by being vaccinated,” he said.

Regarding variants, Dr. Bernstein explained how they are mutants of the coronavirus classic.

“These mutations are simply a mistake when the virus replicates, and all living things make mistakes when they replicate, that’s how evolution works.”

He spoke to the South African mutation, describing it as “very bad mutation” saying, “it is a so-called ‘immune escape variant’ and is a variant of concern as it is about five-fold less sensitive to the antibodies that the current generation of vaccines make.”

Dr. Bernstein said the shape of a protein is changed when it comes to mutations, meaning it is no longer recognized by the antibodies that are elicited when people are immunized by any one of the vaccines now available.

He also addressed the concerns by many of how badly Canada is doing when it comes to vaccine roll-out, and reminds people it is not the complete picture.

“It is not how many vaccines we’ve got; the complete picture is including how many people have gotten sick, or have died.”

He said in the US and UK for example, the US have got a lot of vaccines (35 doses per 100 residents at March 17) with a third of Americans have been vaccinated with at least one dose. He further notes the US high deaths at about 170 deaths per 100,000 people. The UK is even worse.

“In Canada, it is 8.9 doses of vaccines per 100 (at March 17) -11 doses per 100 residents at March 24- and we have lot lower number of deaths at 60 [per 100,000 people], so we are about three-fold lower per 100,000 individuals compared to the US, and almost four-fold lower than the UK.”

“The complete picture is not that we have gotten a lot fewer vaccines. The complete picture is we have gotten a lot fewer vaccines, but we also have a lot fewer cases, and a lot fewer deaths.”

Dr. Gerald Evans

Dr. Gerald Evans continued on the same theme with a presentation on the issue of vaccines and the rise of variants in the first third of the year.

He reminded that Jan. 30, 2020 was when it was declared a public health emergency of international concern, and March 11, 2020 it was declared a pandemic, noting how far we have come since, because we have vaccines.

Evans noted the progression of active cases in southern Ontario over the last year, noting a recent big jump which he said is higher than the second wave, and confirmed we are now into a third wave which is largely being driven by variants.

He said the UK variant, B117, is the variant most frequently being seen right now in Ontario.

“Variants have driven up the effective reproduction numbers in Ontario. Canada has had a really good public health response which the Americans didn’t have, which is reflected in the numbers. The Americans have had over half a million deaths and that’s because they didn’t pay a lot of attention to public health.”

“Most of the variants (93.4 per cent of all variant cases tested) we have been able to distinguish in Ontario, and we haven’t got them all, are mostly B117,” confirmed Evans.

He spoke to how more transmissible the new variants are, and how they are driving up numbers. He also spoke to how Canada is no different to any other country in the world.

“One of the things that we really need to learn about this virus is the things that happen in other countries tend to happen in your country and your jurisdiction,” he said. “When the variants of concern arise and begin to predominate in that jurisdiction, they will generate cases going up and that’s where we are now and that’s what’s causing the third wave.”

Looking at modelling protections to early April, he said cases numbers are going to climb significantly.

“We have to do everything we can to control them. Controlling variants right now is principally public health measures and maintaining those, but vaccines also have an impact.”

He also said there is good data showing the current vaccines are working against the current predominate B117 variant.

“We also have lots of ability to quickly change vaccines using new technology to adapt to other variants that are popping up.”

Talking about what generates variants of SARS-CoV-2, “viruses, just like people, make mistakes”, he said, adding, “that is the driving force of evolution, which is the law of natural selection that drives evolution.”

He says, when anything replicates, and viruses are things that replicate, they can cause mistakes to happen.

“That mistake happens when the enzymes that drive that replications of RNA and DNA actually make mistakes all the time, and one of the ways you stop this from happening is don’t let the virus replicate,” says Evans. “If the virus doesn’t replicate, it can’t make mistakes.”

He goes on to say that one of the mistakes people have made is to allow the virus to replicate like crazy.

Evans said areas of concern are increasing transmissibility, increase in virulence of the virus which makes it nastier and more deadly, a decrease in protection from current vaccines, and in those who have developed an immunity, it may not work against the variants.

He said they are particularly concerned about variants because they transmit really, really fast.

“Air travel, despite being markedly reduced during the pandemic, continues.”

Looking at what is known about the different variants of concern so far, he said while they don’t know much about the Californian and New York strains, the UK variant (B117) is at least 40-50 per cent more transmissible; the Brazilian variant (427429) is 20 per cent more transmissible, with the South African variant about 50 per cent more transmissible and comparable to the UK variant.

The UK B117 variant is dominating the pandemic curve in North America and Europe.

“It is associated with increased transmission, increased risk of hospitalization, ICU admission and death.”

Dr. Evans said it was also important to note that vaccines can induce immunity in different ways.

“Protective immunity relates to protection from severe disease and almost 100 per cent of all vaccines will prevent severe disease, hospitalization and death,” Evans said.

“Sterilizing immunity is what most people think about,” he said, “which is, if I get the vaccine I am not going to get infected.

“We have got some very tantalizing evidence that exists for these vaccines as well, and is probably around 70 per cent.”

He said, transmission immunity, which is an offshoot of sterilizing immunity, if you can’t get infected, you are not going to transmit the virus to somebody else.

He said there is evidence now that transmission immunity is likely as a result of many of the vaccines.

As we enter the third wave of the pandemic Evans summarizes by saying there are a lot of variants floating around which are of concern because of an increase in transmissibility and virulence. The vaccines we have, he said, are effective and safe and there are more on the horizon.

“We are in a minefield and we have to knuckle down with all the public health measures,” said Evans. “Get the vaccine, but keep doing all the good things too, because they are going to help control things as we walk through this little minefield.”

The complete presentation can be found on YouTube by clicking here

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RSSComments (3)

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  1. Fred says:

    Two weeks ago Astravenaca was only approved for those under 64 years of age. Now anyone under 55 years is not approved. What a mess! How would you like to be 56? You’re ok, go for it. Lol

  2. Mark says:

    They could explain the Astravenica vaccine nightmare.

  3. Lynne Rochon says:

    Just wanted to commend Sharon Harrison on her great article on the Covid minefield with two very distinguished doctors……..Bravo Sharon…….we need more like this. Thank you for being there.

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