SARS-CoV-2 Transmission in Alberta, British Columbia, and Ontario, Canada, December 25, 2019, to December 1, 2020

Objective: This study aimed to investigate coronavirus disease (COVID-19) epidemiology in Alberta, British Columbia, and Ontario, Canada. Methods: Using data through December 1, 2020, we estimated time-varying reproduction number, R-t, using EpiEstim package in R, and calculated incidence rate ratios (IRR) across the 3 provinces. Results: In Ontario, 76% (92 745/121 745) of cases were in Toronto, Peel, York, Ottawa, and Durham; in Alberta, 82% (49 878/61 169) in Calgary and Edmonton; in British Columbia, 90% (31 142/34 699) in Fraser and Vancouver Coastal. Across 3 provinces, R-t dropped to <= 1 after April. In Ontario, R-t would remain < 1 in April if congregate-setting-associated cases were excluded. Over summer, R-t maintained < 1 in Ontario, similar to 1 in British Columbia, and similar to 1 in Alberta, except early July when R-t was > 1. In all 3 provinces, R-t was > 1, reflecting surges in case count from September through November. Compared with British Columbia (684.2 cases per 100 000), Alberta (IRR = 2.0; 1399.3 cases per 100 000) and Ontario (IRR = 1.2; 835.8 cases per 100 000) had a higher cumulative case count per 100 000 population. Conclusions: Alberta and Ontario had a higher incidence rate than British Columbia, but R-t trajectories were similar across all 3 provinces.