B.C.'s new period of COVID uncertainty could be the last, or could be the worst

It's a phrase said by health officials so often that it's almost a trope at this point — the next two weeks are critical in British Columbia's efforts to keep cases of COVID-19 under control. 

However, the next two weeks are critical in British Columbia's efforts to keep cases of COVID-19 under control. 

More so than usual. 

"I'm quite optimistic about six months from now," said Daniel Coombs, a UBC mathematician who has helped the province with its pandemic modelling. 

"But it's that short to medium term … that's just difficult."

The reasons are threefold. First, it will be another month before vaccinations in B.C. will substantially ramp up and the weather begins significantly warming.

Second, the province's trend line of daily and active cases has mostly stalled out after fairly consistent declines in December and January, and is now going down at a much slower rate.

The third, and biggest reason, is the slow but steady increase of variants of the virus in British Columbia — and whether enough preventative measures are in place to stop them from overwhelming our system in the weeks ahead. 

Main COVID curve slowly going down, variant curve TBD

Since December, variants of the virus have grown around the world: the most well-known, B117, originated in Britain, but there have been others in South Africa, Brazil, and many other countries. 

Only 15 per cent of positive COVID-19 tests in B.C. are being further tested for variants, because there's only one lab that can do the lengthy sequencing of the whole virus. And while the province is giving data on how many cases have been detected — just 46 at the moment — there's a longer lag time than usual between transmission and confirmation of a variant case.

Caroline Colijn, an infectious disease modeller at Simon Fraser University, says it all adds up to a scenario that makes it difficult to know how quickly variants are spreading in the province, and therefore how effective mitigation efforts have been. 

"While we see our big general curve declining, there's kind of a hidden other curve going on that could be rising. And it could be rising very steeply. And we don't see that because it doesn't ... show themselves until they start rising very steeply," she said.

In January, Colijn produced a model that estimated the province could see 5,000 new cases of COVID-19 every day by the end of March.

It's a worst-case scenario, based on B117 spreading at the same rate here in February and March as it did in the U.K. in December, and with the government changing nothing about its mitigation efforts. 

But it's still on the table.

"I think if there's a risk of complacency, it's probably that people are sick of hearing about the curve and flattening the curve," she said. 

"We've all been doing this for a year. We don't want to hear about another curve."

Two scenarios

Colijn said the new regulations on travel will help, and the province's plan to screen a higher number of samples some weeks will provide a better baseline and understanding of where B.C. is at. 

The results of the first week of increased sample screening were released on Friday, where Provincial Health Officer Dr. Bonnie Henry said just three of more than 3,000 positive cases contained a variant. 

"It tells us we don't have high levels of transmission in our communities, but we still need to be cautious and continue to monitor," she said.

"If we can just get through these next few weeks … I think we'll be in a much better place." 

It sets up the potential for two scenarios in the next month: the suppression of variants until warmer weather and mass vaccinations are underway, allowing for a late spring and summer that could play out much the same as 2020, only with the confidence of vaccines preventing a third wave. 

Or something much more depressing and potentially deadly, which we won't see until it's too late. 

"There's lots of question marks," said Coombs.

"I wouldn't want to try and make a prediction for more than a few weeks from now."