How a Canadian Province Contained the Brazilian Covid-19 Variant

A Canadian province curbed an outbreak of the P.1 coronavirus variant believed to have originated in Brazil through a combination of targeted vaccinations and physical-distancing rules, moves that health experts say can offer lessons to other jurisdictions dealing with rising variant cases.

British Columbia was among the biggest known P.1 hot spots outside Brazil in early April, and the latest data available from the provincial government suggests that variant accounts for roughly one in three new Covid-19 cases. The Western province has attracted attention from public-health experts in Canada and abroad, with many saying decisive actions by the provincial government in recent weeks helped slow the spread, alleviating stress on the healthcare system and reducing the overall Covid-19 caseload.

Experts said British Columbia’s strategy focused in part on traditional methods of dealing with Covid-19, such as banning indoor dining and placing further limits on indoor fitness activities.

“I think that [British Columbia] did a really good job of combining effective nonpharmaceutical interventions with the vaccination strategy of getting vaccines to as many people as possible,” said Dr. James Lawler, an infectious-diseases physician and co-director of the Global Center for Health Security at the University of Nebraska Medical Center. “It’s an important lesson showing that the tools that we already have at our disposal…also work against P.1 and even some of the more concerning variants.”

The P.1 variant is a strain of the Covid-19 virus that is estimated to be as much as 2.2 times more contagious and as much as 61% more capable of reinfecting people compared with previous versions of the coronavirus, according to studies in Brazil. P.1 is believed to be a major factor in the surge of Covid-19 cases in Brazil earlier this year and, more recently, across South America, making many younger people gravely ill.

A Covid-19 vaccination clinic in Richmond, British Columbia. The province is delaying second doses to offer a first shot to as many people as possible. Photo: Liang Sen/Zuma Press

British Columbia first reported 11 P.1 cases in late February, a number that ballooned to 1,510 by early April. There are currently a total of 2,063 cumulative P.1 cases on record in the province, although researchers say that is likely a significant undercount because not all positive Covid-19 cases undergo full genome sequencing.

Officials in British Columbia closed the popular Whistler Blackcomb ski resort in late March after a sharp rise in reported Covid-19 cases, many of which were identified as the P.1 variant. The province later blanketed the area with vaccines in a five-day blitz that made the inoculations available to any adult resident, giving younger people there eligibility for vaccines much sooner than their peers in other parts of British Columbia.

Like other parts of Canada, British Columbia is delaying the second doses of Covid-19 vaccines to offer a first vaccine dose to as many people as possible. Scientists have found that the strategy of administering one shot to reach more people, embraced this year in the U.K., can help prevent deaths and hospitalizations.

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Other public-health measures in British Columbia included a ban on indoor dining starting in late March and restrictions on recreational travel among three main regions of the province announced in late April.

Dr. Althea Hayden, a medical health officer for Vancouver Coastal Health, which delivers healthcare to Vancouver and areas surrounding the city, including Whistler, said imposing the travel boundaries sent an important signal for people when the third wave hit.

“When there’s a change in health orders, it can lead to people changing their behavior,” she said.

British Columbia imposed restrictions on recreational travel between the Canadian province’s three main regions beginning in late April. A sign in Delta, B.C. Photo: Liang Sen/Zuma Press

Across the province, newly-reported Covid-19 cases are down by about 40% from their peak in mid-April.

Newly reported Covid-19 cases in the Vancouver Coastal Health region, where many P.1 variant cases have been concentrated, peaked at roughly 194 cases per 100,000 people in the week ended April 3 before dropping to about half that level three weeks later.

Cases in the Vancouver Coastal Health region “have dropped and dropped and dropped,” said Sarah Otto, an expert in mathematical modeling and evolutionary biology at the University of British Columbia. “That’s good news because it means we’re not seeing P.1 proliferating so much that it’s causing a major spike in cases.”

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She said British Columbia also has better genomic surveillance than many jurisdictions, although it doesn’t make all of that information public, which likely helped officials to design public-health interventions such as targeting hot spots for vaccination.

Scientists use a polymerase chain reaction, or PCR, test to screen samples of the Covid-19 virus for common genetic mutations that are found in variants of concern. British Columbia used to confirm those results through whole genome sequencing. But the province’s top doctor, Bonnie Henry, said last month that effort would be redirected toward more systematic sampling of all strains.

Dr. Henry has said that British Columbia does more genomic sequencing than most countries world-wide, which is one of the reasons it was able to identify so many P.1 cases in the first place.

An aggressive Covid-19 variant called P.1 has spread from the Amazon to other parts of Brazil and has now been identified in U.S. cases. WSJ’s Paulo Trevisani reports from Porto Alegre’s overwhelmed hospitals, where doctors say young people are getting ill. (Published March 19) Photo: Tommaso Protti for The Wall Street Journal

Yet even as British Columbia seems to have gained control over the spread of Covid-19 and the P.1 variant in recent weeks, the neighboring province of Alberta is struggling. Alberta’s seven-day average of reported Covid-19 cases has roughly doubled over the past month and on May 6 reached its highest level since the pandemic began.

Officials in Alberta announced plans last week to close patios, halt indoor fitness activities and move students to online learning, in addition to further restrictions in areas with high caseloads. The province estimates about 45% of active Covid-19 cases involve variants of concern and by May 9 had identified a cumulative 2,155 cases of P.1, or more than British Columbia.

Alberta has announced tougher restrictions, which “are absolutely necessary if we are to reduce community transmission and stop cases from getting out of control,” the province’s chief medical officer of health, Dr. Deena Hinshaw, said last week.

—Vipal Monga contributed to this article.

Write to Kim Mackrael at kim.mackrael@wsj.com

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