Ontario’s vaccination effort requires many communities
How many politicians, bureaucrats and health-care workers does it take to vaccinate a population?
It sounds like a joke, but it is a question that keeps us up at night. Our lives and the lives of our patients, our colleagues, our families, our friends, our communities, hinge upon getting the COVID-19 vaccine.
The challenge of vaccinating millions of adults is a great big wicked problem; one too big for government, or public health alone, to develop solutions for. A wicked problem is one that is difficult, unclear, tests our values and has no singular, simple solution. Vaccination planning is a wicked problem that needs a whole community approach where everybody has a role to play.
The secret to dealing with a wicked problem is to think outside of the box. We need to let go of professional and jurisdictional barriers. We need to move beyond health care’s traditional silos. People and communities are affected differently by the pandemic and will have different ideas and strategies for how to best reach their communities with vaccines. To do that, we have to find ways to trust each other.
A wicked problem will not be solved by one sector and requires the input and efforts of entire communities. People do not exist in, nor do they think they belong to, a single sector, a specific hospital or a single health-care discipline.
We know that the most important way to build vaccine confidence is advice from someone we personally trust. Family doctors, nurse practitioners, palliative care teams, inner city and rural health-care providers, midwives, and local pharmacists are the health-care workers whom our populations know and trust.
They must be at the centre of COVID-19 vaccination strategies. We need to bring vaccinations to Ontarians, where they are, in their communities. Each community has its unique population, challenges and strengths.
By engaging with family doctors and their colleagues in the community, we can ensure that vaccination strategies are developed and delivered within a health equity framework. We require vaccination plans that are attuned to the needs and barriers encountered by seniors, people with disabilities, Indigenous people, people of colour, people who live in poverty, migrant workers, and other marginalized populations across Ontario.
A primary-care oriented COVID-19 vaccination strategy cannot wait. Health-care workers are exhausted and suffering immense moral injury, caregivers are feeling isolated and afraid, patients are worried and anxious, and citizens are confused. The province’s ICUs are reaching capacity and those with other illnesses are not being diagnosed and treated. We need to move as quickly as possible to vaccinate the population so we reach herd immunity to stop the spread of COVID-19.
Ontarians do not have the information they need about the province’s vaccine plans. Currently, communications are unco-ordinated, with different messages coming from different sectors. Information about when and how people can get vaccinated is absent.
We need new ways of communicating with Ontarians so it is clear what the goal is and what’s needed to achieve it, as well as about the details of the vaccine plan as it affects them personally. Transparency and clarity are what will mobilize communities to combine their efforts to move us past the pandemic.
A part of the solution to this wicked problem resides in finding our way back to our North Star — the patient, caregiver, person at the centre of what we are doing. To do otherwise brings poverty to the vaccine effort.
So, what is the answer to the question, how many politicians and bureaucrats does it take to vaccinate a population? Very few, if they empower people in the community, inviting them to the tables where the plans are made. Together, we can get this job done. We have an opportunity to accelerate the distribution of vaccines if we recognize that the answer to this wicked problem lies in the community.
Our vaccine strategy needs a refresh. It needs leadership willing to review it with humility, seeking to find better solutions. We can leave no Ontarian behind. Now is when we can make #InThisTogether more than a hashtag.