Ontario is re-opening its economy today -- again. Brooks Fallis writes that we are on the brink of a third wave:

Canada sits at a pandemic crossroads. Second waves are receding thanks to successful lockdowns and restrictions. Reopening of schools and economies without meaningful improvements in surveillance or containment is set to intersect with emerging variants of concern and vaccine shortages, creating a perfect storm for a massive third wave.

Unfortunately, the pandemic response has become increasingly politicized. In-fighting between different levels of government is now commonplace and directing blame seems more frequent than finding solutions to help us out of the crisis. At government press conferences, wishful thinking is sometimes presented as scientific fact.

In December, the end of the pandemic felt within reach. Vaccines were successfully and safely developed at record speed and huge volumes were promised by pharmaceutical companies. Canada had apparently locked-in an excess of doses. Individual COVID-19 patient mortality was dropping, and many provinces believed they were equipped to navigate second waves with a strategy of graduated restrictions.

Since then, much has changed. The pandemic is clearly far from over and has become decidedly more complex. Governments that failed to leverage appropriate scientific expertise risk being further exposed as unprepared and rudderless as this complexity mounts.

We now face two significant challenges:

The new variants of concern (VOCs) present two major new challenges. The first is a more difficult virus to control and contain. The B.1.1.7 variant is about 60 per cent more transmissible. Early evidence suggests it might also cause more severe disease, and have a higher mortality rate, though we do not yet know this with certainty. Variants are spreading in many communities across Canada. Unfortunately, most jurisdictions lack the ability to identify VOCs in real time.

The second is concern around immune evasion. Some VOCs (B.1.351 and P.1) could cause disease in people with natural immunity from prior COVID-19 infection or immunity from vaccination. Again, more data is needed, but the mere possibility is frightening.

Add to that the problems we have had with getting enough vaccinations into enough arms and it's clear we are a long way from seeing the end of COVID.

Image: STAT