Question Period Note: COVID-19 VARIANTS OF CONCERN

Omicron (B.1.1.529), the newly designated COVID-19 variant of concern, has been detected in Canada.

Key Messages
• Viruses, such as COVID-19 or influenza, are expected to evolve over time. The emergence of the COVID-19 Omicron variant, like Delta and other variants, is concerning but not unexpected.
• Canada has a robust monitoring program in place to detect genetic changes in the COVID-19 virus and to detect any new variants in Canada, including Omicron.
• While it is still too early to determine what Omicron could potentially mean in terms of transmissibility and vaccines, the Government of Canada is acting quickly.
• The Public Health Agency of Canada is carefully monitoring the global situation, and is also working closely with provinces and territories to continue surveillance and research within Canada.
• Chief Medical Officers of Health across the country have been actively monitoring developments regarding the Omicron variant, and are engaged in the response, from a public health perspective, through the well-established Special Advisory Committee on COVID-19.
• Vaccines and public health measures continue to be effective in reducing the spread of the SARS-CoV-2 virus and its variants.
• We encourage all Canadians who are eligible to get vaccinated. Regardless of your vaccination status, everyone in Canada should continue to follow local public health advice and layer individual public health measures. The Government will continue to communicate with Canadians as our knowledge develops.
If pressed on vaccination and variants
• Regardless of vaccination status, people in Canada are encouraged to continue following local public health advice and layer individual public health measures for additional protection. Vaccination and public health measures are working to reduce the spread of COVID-19 and its variants, including Omicron. However it is important that Canadians do not let their guard down now.
• Widespread vaccination will help Canada achieve the best public health outcomes by reducing overall transmission.
• The Government will continue to work with manufacturers to monitor the efficacy and effectiveness of vaccines being used in Canada and will take action if any new variants significantly affect the effectiveness of an authorized vaccine.
• If necessary, authorized vaccines could be modified to address new variants such as Omicron. This process could be similar to what is done every year for new influenza strains. Vaccine manufacturers may proactively begin development against new variants.
• Canada has committed to donating the equivalent of 200 million vaccine doses to the COVAX Facility by the end of 2022. These doses will support global vaccination efforts and help to prevent the emergence of future variants.

Monitoring genetic variations combined with interprovincial and international spread of the virus will become increasingly important as public health measures are gradually lifted and cross-border travel resumes.

Variants of COVID-19, including Omicron (B.1.1.529), could develop groups of mutations that increase the ability to transmit, the severity of disease, the ability of diagnostic tests to work or the ability of vaccines to protect against them. The surveillance systems in place for variants have been developed to monitor for these types of changes. For example, a pattern of transmission that is faster or unusual would be a flag to review the data for a potential variant being present.

A detailed characterization of genetic variations can also help researchers to:
• understand the viral and host mechanisms leading to disease and recovery
• understand how it spreads through populations and other potential hosts
• help identify suitable drug and vaccine targets.

The Public Health Agency of Canada’s (PHAC) National Microbiology Laboratory and provincial and territorial labs monitor for Variants of Concern and Variants of Interest in Canada.

In January 2020, the Pan-Canadian Public Health Network (PHN) activated a Federal/Provincial/Territorial (FPT) Special Advisory Committee on COVID-19. PHN is the main public health table for FPT collaboration in public health in Canada, reporting to the Conference of Deputy Ministers of Health and co-chaired by Canada’s Chief Public Health Officer and the Chief Medical Officer of Health from a province or territory. As per the 2017 Public Health Response Plan for Biological Event, the PHN has the ability to establish a Special Advisory Committee (SAC) as a time-limited mechanism in response to a public health event such as the COVID-19 pandemic

Since January 2020, the SAC has been at the core of the response to COVID-19, including with respect to variants of interest and variants of concerns. As members of the SAC, Chief Medical Officers of Health from across the country coordinate the response to the Omicron variant through the establishment of public health objectives, direction on surveillance, detection and reporting of the variant, advice on border measures, collective approaches to compliance and enforcement as well as to public health measures.
Finding Omicron in Canada was not unexpected, and multiple countries around the world have now detected the Omicron variant. As of November 30, 2021, there have been over 245 detections of the Omicron variant in 21 countries globally, however, the numbers are changing rapidly and several other countries also have suspected cases awaiting confirmation.
The Government of Canada is closely monitoring the Omicron variant in partnership with provinces and territories. The Canadian and global medical, public health and research communities are actively evaluating the variant’s genetic changes to better understand its potential implications in terms of transmission, clinical presentation, and vaccine and therapeutics development.
Canada has donated approximately 5.97 million vaccine doses to Africa, including 1.68 million AstraZeneca (Niger – 100,800; Nigeria – 801,600; Angola – 326,400; Kenya – 459,300) and 4.29 million Moderna (Egypt – 784,200; Rwanda – 1,602,160; Uganda – 1,904,140). The next alottment of donations will include 1.7 million Moderna doses to Egypt, Rwanda, and Uganda.
With respect to Omicron specifically:
• Omicron was originally designated B.1.1.529. Following a meeting of the World Health Organization on November 26, 2021, it was given its name and designated a variant of concern.
• The majority of cases to date have been detected in South Africa, with additional cases now detected in 21 other countries, including Canada.
• As countries begin testing for Omicron, we expect the number of detected cases to increase.
• Omicron has a high number of mutations in both the Spike (the protein responsible for host cell attachment and invasion) receptor binding domain and in the spike N-terminal domain, which is a target for neutralizing antibodies and may impact natural and vaccine-based immunity.
• PHAC is monitoring this variant and has requested rapid notification of cases from PT Partners where it is detected.

Key Facts
• As of November 30, Canada has confirmed 7 cases of Omicron variant (BC=1, Alberta=1, Ontario=4, Quebec=1).
• Omicron (B.1.1.529) has 32 mutations in the Spike protein, which is the protein responsible for host cell attachment and invasion. These mutations may make this new variant more transmissible and/or may impact natural and vaccine-based immunity. However, more study is needed to make conclusions.