As COVID-19 cases continue to rise, many fear this “fourth wave” could send Canadians back into lockdown. Kim Parlee gets the latest developments on the Delta variant, booster shots and when kids under 12 may be vaccinated from Tarik Aeta, Healthcare Analyst at TD Asset Management.
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- Well, the number of COVID-19 cases has been on the rise in Canada, just like it's been on the rise in so many parts of the world, and many of that, for that reason, has been because of the Delta variant and the infectiousness of it, so it has many people trying to understand what's going to be happening with a fourth wave and where it could go. Tarik Aeta is a health care analyst at TD Asset Management. He's here to tell us what he is seeing from his perspective as he watches things, and he's been watching them for a very long time.
Tarik, great to have you with us. I'm going to jump right in. Can you just give us the latest on what you're seeing with the Delta variant in Canada and around the world?
Yeah. Yeah, thanks, Kim, for having me on. Yeah, so taking a step back and looking at the big picture, on a global level the number of cases has been on the rise, once again, over the past two months. And this uptick in cases has largely been driven by the Delta variant across both developed and emerging markets with Delta now the dominant strain across the world.
And looking across the world, it's almost as if we have two separate pandemics running in parallel. In the developed world, where vaccines, in most countries, are now widely available, it has really become a pandemic of the unvaccinated, with the unvaccinated population now accounting for the vast majority of hospitalizations and are 16 times more likely to end up in hospital, with the poster child of that really being the US South, where ICUs are 90% full in states like Texas and Florida.
In emerging markets, where vaccine distribution in most countries has only really begun to ramp up quite a bit more recently, we've seen Delta hit these countries hard, given they're still in the early days of their vaccine rollouts.
And here at home in Canada, while Delta represents 90% of all cases, that's in Canada. We're in a fairly good spot, with 72% of Canadians having received either their first or both their doses, which is ahead of most countries. And while the number of cases are rising here in Canada, the high vaccination rate, combined with the fact that most Canadians have been vaccinated quite recently, which means immunity levels are quite good, will help reduce the impact from a fourth wave. So all in, I wouldn't expect a fourth wave to impact Canada as strongly as it did in the prior two waves earlier this year.
- Well, speaking of being highly vaccinated, you know, we've also had news that Pfizer in the States, of course, has just gotten FDA approval. I think it's the first vaccine that's actually been FDA approved. Then we've also heard the US government talk about the need for-- or talking about-- can we get boosters in at eight months, and then they're shortening it now to five months.
What's your sense of what's going to be happening with booster shots, both in Canada and around the world? I mean, talking about this parallel pandemic, because some countries, to your point, still haven't gotten their first round of vaccines out.
- Right. Yeah, so here in Canada at a national level, the National Advisory Committee on Immunization is still in the process of evaluating boosters. That said, many provinces have gone ahead regardless and have put out their own recommendations. Ontario, for instance, has recommended third doses for vulnerable populations, including immunocompromised individuals and individuals in long-term care.
In terms of the broader public, most public health agencies are still waiting until we get more data on just how durable are the first two shots. And at the moment, the data coming out of Israel, which was one of the first countries to get most of their population vaccinated, suggested that the Pfizer vaccine starts to wane in efficacy around the five-month mark.
And while the Israeli data may be slightly overstating how fast vaccine efficacy wanes, given the first cohort of those that were vaccinated were older adults, you know, that said, I think directionally their conclusions are accurate. So if the public health data coming out from other countries starts to confirm these data points out of Israel, I would expect to see booster approved here in Canada for the broader public probably sometime this fall.
- Tarik, I've only got a couple of minutes but I do want to touch on, coming up in September-- I know in the States kids are already back at school, in Canada they're coming back to school pretty soon-- you know, what are you hearing about 12 and under? Because we could see a wave or a wavelet start just with kids going back to school.
- Right. Yeah, so for both Pfizer and Moderna, they launched their pediatric vaccine trial for children between six months and 12 years back in March. And based on the trial protocols, we should have data for those trials by the end of September. So I wouldn't be surprised if sometime in October we would have a data release from both Pfizer and Moderna and they would apply for regulatory approval sometime after that.
So all in, this basically lines up with comments they've made in the past about aiming to get a vaccine approved in children sometime in the fall of 2021. So wait and see. In the next few months, we should have some data on that front.
- Tarik, I'm going to squeeze in one last question. I mean, we talk about COVID. There's Alpha and now we've got Delta, and I'm sure I've missed some mutations in between.
- Right.
- How do you listen to what's coming in terms of mutations? I mean, what are you hearing about and what is more material to you than what isn't, I guess?
- Yeah. So yeah, so unfortunately COVID continues to mutate and it continues to do so, but that's quite normal for viruses. I guess, really, the million dollar question remains whether the virus will mutate enough to make the vaccines obsolete. And from everything I've seen so far, all the mutations continue to be small enough, with the COVID spike protein largely the same, that the vaccine efficacy continues to be fairly robust.
That said, if we got a mutation that starts to impact the effectiveness of the vaccine, the good news is with mRNA technology we can quickly create a new vaccine and simply replace the mRNA code with new code inside of that vaccine. So all in, I'm not too worried about these variants, given that we have the tools in place to address them, as a society, if they were to become a problem. And yeah, I just keep reviewing the data as it comes out to see whether any of these mutations are large enough to make me concerned.
- Tarik, always a pleasure. Thanks so much.
- Thank you, Kim.
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Tarik, great to have you with us. I'm going to jump right in. Can you just give us the latest on what you're seeing with the Delta variant in Canada and around the world?
Yeah. Yeah, thanks, Kim, for having me on. Yeah, so taking a step back and looking at the big picture, on a global level the number of cases has been on the rise, once again, over the past two months. And this uptick in cases has largely been driven by the Delta variant across both developed and emerging markets with Delta now the dominant strain across the world.
And looking across the world, it's almost as if we have two separate pandemics running in parallel. In the developed world, where vaccines, in most countries, are now widely available, it has really become a pandemic of the unvaccinated, with the unvaccinated population now accounting for the vast majority of hospitalizations and are 16 times more likely to end up in hospital, with the poster child of that really being the US South, where ICUs are 90% full in states like Texas and Florida.
In emerging markets, where vaccine distribution in most countries has only really begun to ramp up quite a bit more recently, we've seen Delta hit these countries hard, given they're still in the early days of their vaccine rollouts.
And here at home in Canada, while Delta represents 90% of all cases, that's in Canada. We're in a fairly good spot, with 72% of Canadians having received either their first or both their doses, which is ahead of most countries. And while the number of cases are rising here in Canada, the high vaccination rate, combined with the fact that most Canadians have been vaccinated quite recently, which means immunity levels are quite good, will help reduce the impact from a fourth wave. So all in, I wouldn't expect a fourth wave to impact Canada as strongly as it did in the prior two waves earlier this year.
- Well, speaking of being highly vaccinated, you know, we've also had news that Pfizer in the States, of course, has just gotten FDA approval. I think it's the first vaccine that's actually been FDA approved. Then we've also heard the US government talk about the need for-- or talking about-- can we get boosters in at eight months, and then they're shortening it now to five months.
What's your sense of what's going to be happening with booster shots, both in Canada and around the world? I mean, talking about this parallel pandemic, because some countries, to your point, still haven't gotten their first round of vaccines out.
- Right. Yeah, so here in Canada at a national level, the National Advisory Committee on Immunization is still in the process of evaluating boosters. That said, many provinces have gone ahead regardless and have put out their own recommendations. Ontario, for instance, has recommended third doses for vulnerable populations, including immunocompromised individuals and individuals in long-term care.
In terms of the broader public, most public health agencies are still waiting until we get more data on just how durable are the first two shots. And at the moment, the data coming out of Israel, which was one of the first countries to get most of their population vaccinated, suggested that the Pfizer vaccine starts to wane in efficacy around the five-month mark.
And while the Israeli data may be slightly overstating how fast vaccine efficacy wanes, given the first cohort of those that were vaccinated were older adults, you know, that said, I think directionally their conclusions are accurate. So if the public health data coming out from other countries starts to confirm these data points out of Israel, I would expect to see booster approved here in Canada for the broader public probably sometime this fall.
- Tarik, I've only got a couple of minutes but I do want to touch on, coming up in September-- I know in the States kids are already back at school, in Canada they're coming back to school pretty soon-- you know, what are you hearing about 12 and under? Because we could see a wave or a wavelet start just with kids going back to school.
- Right. Yeah, so for both Pfizer and Moderna, they launched their pediatric vaccine trial for children between six months and 12 years back in March. And based on the trial protocols, we should have data for those trials by the end of September. So I wouldn't be surprised if sometime in October we would have a data release from both Pfizer and Moderna and they would apply for regulatory approval sometime after that.
So all in, this basically lines up with comments they've made in the past about aiming to get a vaccine approved in children sometime in the fall of 2021. So wait and see. In the next few months, we should have some data on that front.
- Tarik, I'm going to squeeze in one last question. I mean, we talk about COVID. There's Alpha and now we've got Delta, and I'm sure I've missed some mutations in between.
- Right.
- How do you listen to what's coming in terms of mutations? I mean, what are you hearing about and what is more material to you than what isn't, I guess?
- Yeah. So yeah, so unfortunately COVID continues to mutate and it continues to do so, but that's quite normal for viruses. I guess, really, the million dollar question remains whether the virus will mutate enough to make the vaccines obsolete. And from everything I've seen so far, all the mutations continue to be small enough, with the COVID spike protein largely the same, that the vaccine efficacy continues to be fairly robust.
That said, if we got a mutation that starts to impact the effectiveness of the vaccine, the good news is with mRNA technology we can quickly create a new vaccine and simply replace the mRNA code with new code inside of that vaccine. So all in, I'm not too worried about these variants, given that we have the tools in place to address them, as a society, if they were to become a problem. And yeah, I just keep reviewing the data as it comes out to see whether any of these mutations are large enough to make me concerned.
- Tarik, always a pleasure. Thanks so much.
- Thank you, Kim.
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