Location, location and vaccine envy

Socio-economic factors at play, not just age, as rollout of next series of shots gets going

We are seeing a new symptom in the pandemic — generalized vaccine envy.

Ottawa Public Health, guided by the province, has chosen the first number of neighbourhoods where select groups of residents are eligible for the COVID-19 vaccine in March — months ahead of the general population.

It is, relatively, a small demographic portion: those born before or in 1941 (80 or older this year) or any adult who receives “chronic” home care.

To define a neighbourhood, of course, one must put borders around it, meaning 80-year-old-plus residents on one side of, say, Alta Vista Drive, are eligible for the vaccine now but their pals across the street are not. (This is, in fact, exactly the case for a portion of the street.)

So, there will be inequities all over, but defensible ones.

In a perfect system, one imagines, there would be a way to prioritize Ontario's 14 million people so a quite-ill 72-year-old would receive the vaccine before a perfectly healthy neighbour who is 82.

Or a young man sleeping on the floor in a shelter would be jabbed before his siblings living comfortably in the suburbs. The neediest should be served first — this makes sense — but how to do this on a massive scale, in a fairly compact window?

However, if we've learned anything in the last 12 months, it's that perfection eludes us and, as the saying goes, the perfect is the enemy of the good.

OPH has used provincial data-crunching that shows COVID-19 takes a disproportionate toll on older people and those who live in poorer, non-white neighbourhoods and, importantly, those in both categories.

So targeting those areas first is thought to be the best approach to save lives, keep people out of hospital and reduce the pressure on the health-care system.

Where are those Ottawa neighbourhoods with concentrations of older people and racial communities? OPH has named seven: Ridgemont, Heatherington, Ledbury, Heron Gate, Emerald Woods, Riverview and Sawmill Creek.

(For exact boundaries, check the OPH website.)

OPH didn't just guess at which communities should be first. It used the Ottawa Neighbourhood Study, which looked at a number of social determinants that led to better health, including income, education levels, unemployment rates and prevalence of lone-parent families.

The vaccine rollout for over

80s will begin in those neighbourhoods that scored lowest in five “quintiles” or measures of advantage.

Using figures from the 2016 census, OPH says there are

6,765 people over 80 in the 21 most-disadvantaged neighbourhoods. On the whole (2016), Ottawa has about 145,000 citizens over the age of 65 and about 38,000 over the age of 80.

So this week's effort, beginning Friday with the first of three popup clinics, is a modest start.

The city's medical officer of health, Dr. Vera Etches, made the point in accidentally Gretzky-esque terms: don't look at where the puck is, look at where the puck is going.

In other words, these neighbourhoods are not necessarily COVID hot spots, but have the potential to become ones.

“The decision to locate a popup clinic in a community cannot solely rely on where there are actually clusters of COVID-19 because these are continuously changing and do not accurately reflect the vulnerabilities of the community,” she wrote to the mayor and councillors last week.

Indeed, the COVID-19 “science table” that is advising the province projected there will be 18 per cent fewer hospital admissions if you mass distribute a vaccine based on age and neighbourhood, over just age alone. So, absolutely, location matters.

Which is not to say there won't be grumbling. If you look at streets like Vancouver or Kitchener avenues in the Ridgemont area, these are hardly poverty row, but parts of solid, middle-class neighbourhoods with some fine houses.

And there will, of course, be problems. Jacques Beaulne, 81, lives in Riverview — a designated neighbourhood — in one of three towers in the Riviera group on Riverside Drive.

He was surprised to discover on Tuesday that his postal code was rejected but those in an adjacent building were accepted. Huh? (Not lost on him, either, is the fact these are considered “luxury” condos and not part of a socio-economically depressed area.)

“Please explain why this address (other residents of this building have also been rejected) is not considered to be within the Riverview borders when in fact it is,” he wrote to public health.

Please explain? Ottawa Public Health will be doing a good deal of that this month, evidenced by 1,000 phone calls on Monday alone.

Vaccine envy, evidently, is highly contagious.