What to expect from COVID-19 variants this fall

“Vaccines are like seatbelts in a car: they’re going to reduce infection risk, and they’re critical in the ongoing fight against COVID-19 variants.”


With COVID-19 spreading rapidly again due to newer Omicron variants such as EG.5 and HV.1, and with many scientists continuing to watch the highly mutated variant of the virus BA.2.86, public health experts say that we’re in the midst of a wave, and that Canadians can expect COVID-19 infections to continue over the fall and winter.

Dr. Fahad Razak
is a general internist at St. Michael’s Hospital, Canada Research Chair in Data-Informed Healthcare Improvement and the former scientific director of Ontario’s COVID-19 Science Advisory Table. He spoke with us about the severity of the Omicron subvariants now circulating, as well as the importance of receiving the latest vaccines and continuing to mask in certain circumstances.

How seriously should we take COVID-19 this fall season?

We are in the midst of another uptick in COVID-19 infections. This was expected. After all, we know that, as the virus continues to evolve and mutate, and as population immunity wanes, we’ll see rises in cases periodically.

But unlike the crisis we faced during the first few years of the pandemic, this COVID-19 wave is unlikely to cause severe illness for the majority of Canadians. In fact, the chances of becoming seriously ill—and ending up in the ICU—from COVID-19 is relatively low for most people.

There’s a lot of immune protection already in place, which should be recognized and celebrated. But still, I believe we should always try and prevent infections wherever possible because they’re so unpredictable: sometimes people get very sick from COVID-19 for reasons we don’t fully understand, and there’s always the risk of long COVID.

Medical experts say that EG.5 is related to the variant currently targeted by vaccines. Will the next COVID-19 booster offer sufficient protection from this and other new variants?

The newest versions of the vaccines being rolled out now closely match the version of the virus currently circulating, and they’ll provide enhanced defence against severe disease which, hopefully, will carry us through the winter respiratory virus season. They offer cross-protection against EG.5 and other Omicron variants that emerged this year. In that way, the latest vaccines are like seatbelts in a car: they’re going to reduce infection risk, and they’re critical in the ongoing fight against COVID-19 variants.

Who should consider getting the vaccine this upcoming season, and does it matter which vaccine they receive?

Health Canada has now approved Pfizer's and Moderna's updated vaccines for people who are aged six months and older. Both vaccines are available now for select high-risk populations and broader roll-out will follow shortly.

The people who will especially benefit from these new vaccines are those who are of older age, who are immunocompromised, who are in long-term care or high-risk communities, or who are serving as frontline workers. By and large, these groups are at risk of severe disease with each new round of infections, or in the case of frontline workers, much more likely to be exposed.

For otherwise healthy adults who don’t fit into these categories, the vaccination recommendations are more neutral. But I, like many others, will go out and get vaccinated to minimize the disruptive impact of infections. And I suggest getting the first vaccine that’s available to you; there’s no convincing evidence that either Moderna or Pfizer is superior.

How likely are we to see more mask mandates during the next COVID-19 wave?

It’s very unlikely that a general mask mandate—as a means to reduce or prevent infection—will be considered by most governments, unless there’s a significant change in the nature of the virus. But masking in higher risk environments, such as hospitals, schools and public transit, could be a significant early strategy if we again reach a critical state. During periods of high transmission, it continues to be an important part of our approach to reduce the spread of the virus.

To what extent will new COVID-19 variants be disruptive for the healthcare system if we don’t take preventative measures?

The consequences of each wave of COVID-19 infections, and the combined effect of multiple waves of respiratory viruses—such as influenza and respiratory syncytial virus (RSV)—are worrisome for hospitals. Given constraints in healthcare human resources, anything that increases case loads will affect wait times and system pressures, repeating a vicious cycle that has sent healthcare systems into crisis during the pandemic.

Remember that we saw record waiting times and ER closures last winter. So, protective strategies, such as keeping your vaccines up to date and masking in crowded indoor settings during COVID-19 waves, are still important: whatever can be done to alleviate the burden of infections reduces that strain on the healthcare system.

Is there a reason for us to remain hopeful about COVID-19 protection?

Despite the sharp rise in COVID-19 infections during this wave, we have seen very little increase in people with severe disease requiring hospitalization or patients on ventilators. That reflects the level of broad immunity against severe disease.

And like many of my colleagues, I was thrilled to see the Nobel Prize in Physiology or Medicine awarded to two individuals who led the critical basic science around mRNA vaccine development. These vaccines are a medical miracle, and having access to tailored and updated vaccinations is truly remarkable. For the first time in human history, we have vaccines against all major respiratory viruses that are circulating: COVID-19, the flu and RSV. Such scientific advances saved many millions of lives during the pandemic and will continue to protect us this winter season.

That’s why we’re in a much better position today than we were a couple of years ago. That’s what gives me hope. So we have the tools to protect ourselves, our families and friends, and the healthcare system this winter. Let’s use them!

Donate to St. Michael's Foundation.

Want to share this story?


Get monthly updates on the latest in medical discoveries and the best events, and meet patients and donors who support our hospitals.