Better days forecast, darkened by outbreak of politics
Did you feel it? That burst of optimism? It’s what happens when temperatures climb above freezing in Toronto, and a new vaccine is approved. Friday was another good day for science, partly because the AstraZeneca COVID-19 vaccine was approved by Health Canada, leaving the country with three vaccines to choose from. A prospective fourth, Johnson & Johnson, was supported by a key U.S. Food and Drug Administration panel, and is said not to be far from approval here. Better days are coming.
And Ontario’s Science Table demonstrated that by prioritizing vaccinations by postal code, we can save lives, and end the pandemic sooner. Meanwhile, vaccination priority in homeless shelters was approved by the province, which like vaccinating by postal code was smart, humane, and equitable policy. Finally. It was a good day for science.
Simultaneously, Friday felt like the capper of another bad week for science, because the wrestling match between science and the people in charge that has been occurring for the last 11 months in Ontario continues. Wednesday was retired Gen. Rick Hillier’s vaccination timeline, which was already nonsense when he said it — 60-plus people only getting vaccinated after Canada Day, which doesn’t match the vast majority of likely scenarios — and then Friday’s widely expected vaccine approval crumpled it up and threw it away.
It was a bizarre underpromise, and required cleanup up to and including Minister of Health Christine Elliott. If you add up the total vaccines that Canada has coming, plus Johnson & Johnson, the less sure addition of Novavax, at least 1.9 million from the COVAX fund, two-million doses from AstraZeneca from Serum Institute in India, and some higherthan-expected delivery numbers, Canada could have enough vaccines for approximately 26.4 million people by the end of June.
That is likely an overpromise. But it’s possible. Meanwhile, there is probably a reason local public health units are setting up their own vaccination portals and schedules and timelines in the absence of provincial leadership. Anyway, that’s the guy in charge of distributing vaccines in Ontario.
Thursday there was the testimony of chief medical officer of health Dr. David Williams to the Long-Term-Care Commission, which the province is trying to bury in documents before an unreasonably early deadline for a report.
The testimony was both astonishing, and expected. The doctor casually mentioned that he did not accept asymptomatic spread of the disease until late summer, at which point reopening plans were well underway. He claimed that Dr. Shelley Deeks of Public Health Ontario, one of the most courageous whistleblowers of the entire pandemic, was fine with the lunatic framework that Williams himself approved in November, before the province clambered down.
Asymptomatic spread was assumed as early as February 2020; Alberta Health Services, to take one example, said it was plausible in early April. In the testimony, Williams indicated he wasn’t entirely convinced of it now. Williams has been criticized in more medical circles than I can count, and should never have been extended, much less kept.
And Deeks now works in Nova Scotia, while Williams stayed. Anyway, that’s the guy in charge of public health in Ontario, more or less.
Then Friday, there was more failing of the marshmallow test by politicians like Patrick Brown and Bonnie Crombie, the mayors of Brampton and Mississauga, respectively. At times, they have backed their medical officer of health, Dr. Lawrence Loh, and deserve credit for that. But now Brown and Crombie are agitating for a return to the red level of restriction if cases drop below 100 per 100,000 per week.
One of the craziest things about that initial November framework was that to move into red, you needed 100 cases per 100,000 people per week, among other things. Peel is sitting at 97.6, with an effective reproduction rate, or R, that rose from 0.9 to 1.0 this week, despite restrictions.
And the percentage of more transmissible variants was nearly 20 per cent of total Ontario cases Friday; the seven-day average is 17.9 per cent, and climbing.
“What we see in the data is a progressive increase in (the) B.1.1.7 (variant), exactly as predicted three weeks ago,” says Dr. David Fisman, epidemiologist at the University of Toronto, and a member of the province’s independent volunteer science table. “The R for new variants is 1.29, and old variants is 0.87. So as new variants become more common, that’s going to push overall R back up.”
Anyway, those are the mayors in charge of the hardest-hit region of the pandemic in Ontario.
This entire year has been a wrestling match between some of the best scientific and medical minds in a province full of them, and the people in charge, who largely care about reelection prospects. We have a wealth of medical and scientific talent. We could have done great.
But we haven’t. So at least Ontario pulled the emergency brake Friday, moving Thunder Bay and Simcoe-Muskoka back to the grey lockdown level. There was some apprehension in the public health community over whether the province would actually use the measure; that Ontario did means at least they will react to circumstances on the ground. It felt like another win for science.
Except ... is it an emergency brake? Just like the old restrictions, the measures were announced on a Friday, and will be implemented the following Monday, no rush. Just like the old restrictions, the districts will move into the grey level of the Ontario framework, without the stay-at-home order that was a key part of the measures that drove down Ontario’s case counts from January on.
Which would make this the old framework, with a new bumper sticker name. The next four weeks could be the most dangerous of the pandemic. Dr. Eileen de Villa says it in Toronto; Dr. Peter Juni, the scientific director of Ontario’s volunteer Science Table, says the same. But then, they’re not really in charge.
Better days are coming. But the wrestling match, exhausting as it is, isn’t over yet.