Earth to Ottawa: Keep eye on the ball
‘B. C. sticking with vaccine plan despite calls to immunize racialized groups sooner.” That was a CTV News headline this week after dr. bonnie Henry, british Columbia’s provincial health officer, told reporters she had no plans to alter her vaccine rollout plan in light of new guidance from the National Advisory Committee on Immunization (NACI). It nicely encapsulated a frustrating media narrative that has coalesced around the idea of prioritizing minority groups.
“The new recommendations prioritize racialized adults from groups disproportionately affected by the pandemic ahead of some older non-racialized people,” The Canadian Press reported.
“Two public health experts in Toronto say governments must prioritize vaccinating black Canadians and other people of colour against COVID-19 because the data shows they are most at risk of contracting the virus,” CBC reported.
This is wildly oversimplified. NACI’S basic idea is sound: At some point in the vaccination process, after we have immunized the people likeliest to die of COVID-19 and those likeliest to transmit the virus to those likeliest to die, it makes sense to focus on communities and neighbourhoods that have proved to be the most vulnerable. It’s the most efficient way of saving lives, preventing community spread, freeing up hospital beds, reducing suffering and stress, keeping the economy moving.
It is true that many of those neighbourhoods aren’t very Caucasian. In Toronto, which has reported demographic breakdowns of cases up to december, Latin Americans represented three times the proportion of COVID-19 cases as of the city’s population.
Also significantly overrepresented were Middle eastern or West Asian (2.1 times), South Asian or Indo-caribbean (two times), southeast Asian (1.8 times) and black (1.6 times) Torontonians.
Neighbourhood-level data bears that out: the most affected areas are all heavily populated by one or more of those groups.
but there’s no evidence any of them are biologically more vulnerable, and no one claims otherwise. People in those areas are more vulnerable because they are likely to live in crowded, multi-generational or multifamily households.
They are more likely to hold jobs that cannot be performed remotely, and that are common sources of outbreaks: food processing, meat packing, health care. They are more likely to be living paycheque to paycheque, and thus to overlook symptoms and go to work. They are more likely to have underlying conditions.
In the long term, fixing all that is society’s job. In the short term, we need to deploy these vaccines as unemotionally as possible to reap the maximum communal benefit at every step in the process.
understanding cultural differences is a key part of that: We know vaccine hesitancy is much higher in some communities than others, and it needs to be addressed. but there is no good reason to be prioritizing anyone for a jab with anything in mind other than maximizing the public good. Meat packers should get priority because there are a lot of outbreaks in meat-packing plants, not because they are “unsung heroes,” as a recent Toronto Star op-ed argued, or to “recognize the sacrifice,” as Saskatchewan chief medical health officer dr. Saqib Shahab suggested on Wednesday.
To be fair to NACI, it’s not actually proposing what the headlines suggest. The priority group it added to Phase 2 of the rollout is “adults in racialized and marginalized communities disproportionately affected by COVID-19” — i.e., not all racialized or marginalized communities. but it would make far more sense if they just deleted the words “racialized and marginalized.” Any community disproportionately affected by COVID-19 is equally worth prioritizing. The determining factor should be (and almost certainly will be) postal code, not skin colour.
As for that CTV headline, Henry didn’t so much say that her plans weren’t changing as that her plans already incorporate the approach NACI proposes. b.c.’s plan as written focuses mostly on age; it doesn’t mention hard-hit communities specifically. but there is ample room within that plan to prioritize people of any age who are living in vulnerable communities. “What we are focusing on is making sure that we can monitor who’s being immunized and address those populations who are not equally accessing vaccine at the same time,” Henry told reporters on Wednesday. Quite right.
Why should it be news in the first place that Henry, who has overseen what is clearly the best provincial pandemic per1.00.80.60.40.2.0 formance west of New brunswick, doesn’t plan to take up every piece of non-binding federal advice that gets published? What on earth makes anyone think the feds know better than the provinces; that one vaccine-rollout approach should be common to all provinces? The only real question anyone should be asking Ottawa at this point is “how many vaccines and when?” This is an easily distractible country; now is very much the time to focus our minds on what really matters.