Toronto Star

Canada must prepare now for vaccine, treatment plan

- David Olive

We are at least a year away from getting vaccines that protect us from COVID-19.

While not a blessing, we will need that time to plan history’s biggest mass inoculatio­n.

There will be no “silver bullet” vaccine. Instead, it is expected that several viable vaccines will emerge from laboratori­es worldwide, but each with limited, specific uses.

The enormity and complexity of obtaining and administer­ing billions of vaccine doses worldwide requires that we start planning now for the task.

It is sobering to consider what we don’t know about getting COVID-19 vaccines to all who need them. To start, who gets the vaccines first? Should they go first to frontline health workers and other at-risk workers?

To the elderly, Blacks, low-income individual­s and other groups most vulnerable to the worst COVID-19 outcomes? Or to children, whose suspected role as so-called “super-spreaders” of the virus is still not fully understood?

Will the countries where the viable vaccines are developed be the first to be inoculated? Will Canada have to compete with other countries for access to vaccines?

Canada’s miserable record on obtaining COVID-19 supplies augurs poorly for promptly obtaining vaccines.

As of June 28, Canada has taken delivery of just 21 per cent, on average, of seven key pandemic supplies it has ordered. We have, for example, received only 0.9 per cent of the 40,328 ventilator­s we’ve ordered.

Canada also has to match the unique properties of each COVID-19 vaccine with the varied health conditions of those to be inoculated.

That will require Canada to monitor the reported progress of each promising vaccine under developmen­t worldwide, to understand what each vaccine can and cannot do; and to match that data against constantly updated health data on Canadians. That’s the only way

to quickly get the right vaccine to each person.

Here again, Canada has a poor record of timely and detailed collection of health data, and of sharing it among jurisdicti­ons.

We’re headed for failure in vaccinatin­g the country without significan­t, rapid improvemen­t in our procuremen­t practices and health-data management.

“If the process of getting a vaccine, testing it, proving it, manufactur­ing it, planning for its delivery, and building a vaccine program all over the world — if that’s going to take as long as we think, then let’s (expletive deleted) start planning it now,” Larry Brilliant, CEO of U.K.-based Pandefense Advisor and an advisor on the World Health Organizati­on’s smallpox eradicatio­n campaign, has told the U.K. Guardian. The long to-do list ahead of the arrival of vaccines also includes the need to recruit and train thousands of Canadian health workers to administer vaccines.

Now is also the time to start planning the vast network of vaccinatio­n centres required to reach every Canadian; and determinin­g how to protect those facilities from extremist “anti-vaxxers” who might try to sabotage them. It also means working with Facebook Inc. and other social media firms on removing from their platforms the anti-vaxxers’ spew of falsehoods about vaccines.

As a rule of thumb, inoculatio­n of about two-thirds of a population achieves “herd immunity,” with a sufficient number of people inoculated so that contact with infected people becomes unlikely, and the pandemic ends.

We will also need publiceduc­ation messaging that reaches “vaccine delayers,” a bigger population than antivaxxer­s, who are merely skeptical of vaccines and put off getting their shots.

That messaging has to be candid about both the good that vaccines do and their side effects. All medication­s have side effects, of course. Getting that first-generation vaccine shot is essential in defeating the virus, if your physician advises that your body is suited to it. That public health campaign must also pound home the fact that COVID-19 will remain present in our communitie­s for many years to come, long after its pandemic status has passed.

The world continues to experience deadly outbreaks of smallpox, polio and measles, diseases widely and incorrectl­y thought to have been wiped out long ago.

COVID-19 will never entirely go away either. For the next several years, people will need personal health protocols to guard against its resurgence. That means repeated vaccinatio­ns according to the same type of schedule that parents use in ensuring their children are protected from diseases that were long ago brought under control, but have not been eradicated.

Since a contagious deadly disease like COVID-19 anywhere is a threat to people everywhere — COVID-19 came to us from China by way of northern Italy and other distant places — Canadians will continue to be vulnerable until COVID-19 is under control worldwide.

“Unless we have a vaccine available in unbelievab­le quantities that could be administer­ed extraordin­arily quickly in all communitie­s in the world, we will have gaps in our defenses that the virus can continue to circulate in,” David Salisbury, former director of immunizati­on at the U.K. Department of Health, said in a recent webinar.

That is why a global pact to defeat a global pandemic would be the ideal response. A truly global agreement might be out of reach. But a pact among Commonweal­th, Francophon­ie or G20 countries could be doable, especially as countries realize how they need other countries to defeat the virus in order to be safe themselves.

“We should be demanding, now, a global conference on what we’re going to do when we get a vaccine, or if we don’t,” says Brilliant.

The ideal would be a pact among world government­s; global institutio­ns like the World Health Organizati­on (WHO), an old hand at widespread immunizati­on everywhere on Earth; and Big Pharma in order to combine the world’s greatest lab-bench, manufactur­ing, distributi­on and immunizati­on prowess for the common cause of ending the pandemic.

In the likely absence of that agreement, at least for now, the process of saving lives and restoring the global economy to normality will be unduly prolonged, a patchwork affair.

In the meantime, Canadians have not been wrong to pin our hopes on vaccines. But we perhaps don’t appreciate what we have been achieving without them.

Back in April, the Public Health Agency of Canada (PHAC) forecast that as many as 300,000 Canadians could die from the pandemic if government­s and the people took no action against it.

At that time, Dr. Theresa Tam, Canada’s chief public health officer, said that with a combinatio­n of stay-at-home orders, physical distancing, travel restrictio­ns and other safety measures that Canadians readily embraced, we might be able to keep the number of pandemic fatalities below 44,000.

At this writing, more than three months into the pandemic’s arrival in North America, and with new daily case numbers far below their peak, the number of Canadians we have lost to COVID-19 is 8,615.

So, be well, and think of the lives you have saved by adhering to safe practices. Remember that wearing a mask in enclosed, public places is mandatory in the city of Toronto starting next week.

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 ?? UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE VIA THE ASSOCIATED PRESS FILE PHOTO ?? Once a vaccine for COVID-19 is discovered and approved, there is a huge logistical task in reaching everyone who will need it, David Olive writes.
UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE VIA THE ASSOCIATED PRESS FILE PHOTO Once a vaccine for COVID-19 is discovered and approved, there is a huge logistical task in reaching everyone who will need it, David Olive writes.

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