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CANADA: Threat from variants means provinces must be ready to lock down again quickly, Tam says

Tam's words come as Trudeau takes another step toward keeping more variants from getting into Canada, with a plan to start making people arriving in Canada by land show a recent negative COVID-19 test

OTTAWA — With new and more contagious variants of COVID-19 escalating in Canada, provincial governments lifting lockdown restrictions need to be ready to slam them back in place at a moment's notice, Canada's chief public health doctor said Tuesday.

At the same time Prime Minister Justin Trudeau took another step toward trying to keep more variants from getting into Canada, with a plan to start making people arriving in Canada by land show recent negative COVID-19 tests.

Chief public health officer Dr. Theresa Tam said Canada probably doesn't have a full picture of the Canadian presence of more-contagious variants of the virus behind COVID-19. But because they could become the most prevalent sources of infection in Canada, any sign that they're beginning to spread needs to be met with a rapid and decisive public health response.

"You've got to put the brakes on quickly," she said.

While overall case counts have declined in the last week — something Tam said is excellent — the number of cases of the variants has doubled.

She said the number of cases of the variants has doubled in the last week, and the B.1.1.7 variant that was first identified in the United Kingdom has a very good chance of becoming the most common source of COVID-19 infections in Canada. It is believed to be 35 to 40 per cent more transmissible than the original SARS-CoV-2 virus that has been behind most of Canada's infections to date.

"It's just going to be more difficult to control one once the acceleration occurs," said Tam.

But Tam said Canada is not yet screening every positive case to see which variant is behind it. That may begin to happen as total positive cases drop, making it easier to screen them all.

Several provinces are lifting strict lockdown measures as case counts continue to come down. Ontario and Quebec both reported their lowest daily counts since mid-autumn on Tuesday.

Quebec began loosening its restrictions Monday and Ontario announced Monday it will begin ending its stay-at-home order over the next week for most of the province, and for the hot zones in and around Toronto later in February.

Trudeau hasn't yet implemented a plan to force air travellers to stay at quarantine hotels for three days after arriving, but he said as of next week, non-essential workers arriving at land borders will have to show negative PCR COVID-19 tests completed less than three days before arriving.

Travellers who arrive without the test results will be fined up to $3,000 and subjected to increased enforcement of quarantine measures. However land travellers are not currently going to be sent to the mandatory quarantine hotels.

The government began requiring all people arriving in Canada by air to show negative PCR-based COVID-19 tests in early January.

Trudeau said Canadians arriving by land can't be refused entry because they're already on Canadian soil when they meet with border guards. Air travellers getting on planes on foreign soil can be denied boarding without the tests.

"That's why what we can do is in cases of no test to show, apply a stiff penalty, a fine, and demand and ensure a rapid and complete followup to make sure that they are getting tested, that they are being properly quarantined, that they are not putting at risk the safety of other Canadians by returning home without a clear negative test," he said.

The latest statistics from the Canada Border Services Agency show that since the end of March 2.9 million people, excluding truck drivers, entered through land border crossings, while 2.4 million arrived by airplane.

Health Canada's chief medical adviser Dr. Supriya Sharma also said Monday the department's vaccine review team agrees with Pfizer and BioNTech that each vial of their vaccine contains six doses, rather than five.

Getting a sixth dose out of a vial requires a special syringe that allows less vaccine to go to waste, and Canada is starting to ship the first two million of those special syringes to provinces this week.

The change means Pfizer will fulfil its contract to ship four million doses to Canada by March by sending fewer vials. 

Maj.-Gen. Dany Fortin, the military commander overseeing Ottawa's vaccine distribution program, says next week Canada will get the same number of vials it was expecting, but instead of Pfizer saying those 67,275 vials contained about 336,000 doses, they will count them as 400,000 doses.

The week after that, Canada will get 79,170 vials, which will now be counted as 475,000 doses instead of the previous 395,850 doses. 

Pfizer's vials typically contained about 2.25 ml of vaccine once the dilution solution is added. Each dose is only 0.3 ml, which means even at six doses, almost half a millilitre is left.

Medical professionals began noticing they had enough left for sixth doses when the vaccine was first approved in December, but Health Canada's advice up until the announcement Tuesday was only to extract that dose if possible.

The label change requires the company to take reports on difficulties getting that sixth dose and to give some education assistance.

Health Canada is also providing webinar training this week to guide medical professionals in how to get the sixth dose.

Canada's contract with Pfizer and BioNTech is to buy 40 million doses this year, with four million to be shipped by the end of March, and most of the rest before the end of September.

The United States, Europe and the World Health Organization all made the dose change last month.

This report by The Canadian Press was first published Feb. 9, 2021.

Mia Rabson, The Canadian Press