2 new COVID-19 subvariants are growing twice as fast as B.A.5 in Ontario, public health agency says

The former head of Ontario's COVID-19 science advisory table says it is time to bring back mask mandates as Public Health Ontario says the proportion of the new BQ.1 and BQ.1.1 Omicron subvariants in the province is growing twice as quickly as the dominant BA.5 strain.

Dr. Fahad Razak, an internist at St. Michael's Hospital, says in August and September the health system was showing the kind of strain that's normally seen at the peak of a bad flu season and there is very little capacity to respond to increases in COVID-19 rates.

"For anyone who says, 'Let's not do that,' I would ask, 'What is the alternative at this point? How do we keep the system that has so little capacity, how do we get it to continue to run over the winter?"

Public Health Ontario said in a report this week that COVID-19 activity in the province is generally stable, though it has been gradually increasing since early September. While not a lot is known yet about the BQ subvariants, there is a high risk of increased transmissibility, reinfection and lowered vaccine effectiveness, it says.

 "A COVID-19 pandemic strategy that relies entirely on immunity from current vaccines and past infection will be limited in its ability to affect transmission," the report said. 

"Continuous [whole genome sequencing] surveillance, monitoring of the impacts of implementation/removal of public health measures, and efforts to increase vaccine equity can all help prepare Ontario for the next stages of the COVID-19 pandemic."

Ministry mum on mask mandates

Razak says if he were still in his advisory position — the science table was dissolved last month — he would recommend reintroducing mask mandates for essential settings such as public transit, grocery stores and schools.

He says neither masks nor vaccines alone are a perfect solution, but together they can keep COVID rates down and ensure people have access to health care when they need it.

When asked about mask mandates, Hannah Jensen, a spokesperson for Health Minister Sylvia Jones, said the ministry is committed to ensuring the health and safety of all Ontarians.

"COVID-19 vaccinations and boosters remain the best tool to keep people healthy and out of hospitals," Jensen wrote.

"The bivalent vaccine, along with continued access to testing and antivirals and updated public health guidance, gives Ontarians the tools they need to make the best decisions for themselves on how to stay safe [and] healthy."

Dr. Gerald Evans, an infectious disease expert at Queen's University, says Ontarians should not be "overly worried" at this point about the BQ subvariants, though the growth rate is a cause for some concern.

Flu admissions could add to hospital load

Razak said he and his colleagues are also starting to admit patients with the flu to hospital — something he has not had to do in the past two years when public health measures such as masking kept not only COVID-19, but other viruses like influenza at bay.

"Flu has historically stressed our system," he said. "It has caused massive problems."

Public Health Ontario said flu season has not yet started, though positivity and case numbers are on the rise — increasing from 158 lab-confirmed cases in the week ending Oct. 15 to 321 cases in the week ending Oct. 22.

Meanwhile on Thursday, Ontario reported 1,921 COVID-19 hospitalizations — the highest reported hospitalization rate since February, along with 121 more COVID-19 deaths.

The hospitalizations are a jump from 1,663 at the same time last week, when the province reported 109 new deaths.

Not since Feb. 9 has Ontario seen COVID-19 hospitalizations this high. On that day, the province reported 2,059 people in hospital with the virus.