▪ Once this wave started rolling, vaccines weren’t going to stop it,
We need vaccines in Scarborough; we need vaccines in Peel. We need vaccines in the postal codes where nearly a third of Ontario lives, and vaccines for seniors, and vaccines for those with medical conditions. Everything is an emergency in this province now, and we need vaccines. It’s a problem.
What we have instead is a vaccine rollout that seems utterly chaotic. Appointments were cancelled all over this week, due to a lack of supply: University Health Network, North York General Hospital, East Toronto Health Partners’ Thorncliffe Park clinic, and Scarborough Health Network, through the end of the week. It was a mess.
The whole thing seems a mess, and some of it actually is. Let’s sort through and figure out what the problem actually is.
Moderna was a small problem. The province blamed the cancelled appointments on a delayed Moderna shipment, except that shipment was originally supposed to arrive between April 5 and 11, and was in Hamilton two days later, on the morning of April 13. Allowing for 24 hours to send it to a central processing centre and another 24 hours to get it to GTA locations, it should have been ready Thursday morning.
Still, Moderna was only 20 per cent of the missing doses. Scarborough was supposed to get Pfizer. A week earlier, a slide in a presentation from the Toronto Health Sector Vaccine Leadership Table — which is cochaired by Toronto Public Health and Ontario Health, and decides where vaccines go — indicated that as part of the province’s sudden shift to priority vaccination for hot spot postal codes.
“(We were told) vaccine was going to be provided into communities with that equity lens,” said Dr. Bert Lauwers, executive vice-president and acting chief of staff at Scarborough Health Network, which had to cancel 10,000 appointments. “But that didn’t happen, and that’s what’s got us between a rock and a hard place. The Pfizer reallocation that never happened was the top piece, and that’s where we’ve landed today.”
Maybe it was a miscommunication: the province intends to divert 100,000 of the weekly 400,000 doses of Pfizer in April to high-risk postal codes, starting in Peel and Toronto. But it’s unclear when that truly starts. Toronto Public Health, for its part, says the Moderna delay was a problem, but didn’t explain the Pfizer piece; it also said the sudden strategy shift caused confusion, and that one scans.
Priority for high-risk postal codes is critical: as Lauwers says, “We have 632,000 people (in Scarborough, 22 per cent of the population of Toronto, and we’ve never been given 22 per cent of the vaccine. Not even close. And in addition to that, 73 per cent of our people are visible minorities, and you know how this pandemic has disproportionately affected multi-generational family households, visible minorities, and lower socioeconomic status.”
So the cancellations are a problem, but not the problem. So what is? It’s not vaccines in freezers. About half of the 1.1-million doses in freezers is AstraZeneca, which is moving slowly at the pharmacies after some exceedingly low-risk links to blood clots. Health Canada is now saying there should be no age limits on the use of the vaccine. Hopefully, people listen. The rest of the vaccines move faster.
Hot spot reallocation is a problem, but not the problem. Last week Premier Doug Ford made it sound as though hot spots would be flooded with mobile teams, and that everyone 18 and over would be eligible to be vaccinated, fast.
But the sudden shift in strategy was dumped on overwhelmed public health units, with little supply for 4.2 million people in those 114 high-risk postal codes. So the start of the plan is more of a microtargeting to those who need it most: that’s why you saw a pop-up in Thorncliffe Park, or at a Hindu temple in North Etobicoke. Expect an Amazon factory at some point. That targeting is how it should be: this correspondent lives in a high-risk postal code, but is privileged enough not to be high risk.
“They made an announcement without a plan, or a supply to implement it,” said one source familiar with the provincial pandemic response. “A, there was no supply. B, people couldn’t register for appointments. C, there was no plan.”
So a lot of people are hunting appointments that don’t and won’t exist, and people in hot spots who aren’t actually part of truly vulnerable populations should hunker down and wait. As the Star’s Jennifer Pagliaro reported, the smart play was always to treat vaccination like an election: preregister everyone, then sort through the line. It’s a pity we didn’t. It could alleviate a lot of stress.
Still, that’s not the problem, either. It would clearly help if there was more vaccine, and more or less every nation on earth could say the same. But Canada is now ranked 20th in the world in first doses among comparable nations, 16th among nations who did not take shipments of the less-efficacious Chinese vaccine, and no dreadfully superficial CNN report can change that, no matter which opposition party brings it up. The lists showing Canada at 55th were always predicated on counting every minuscule jurisdiction on earth — how could we rank behind Montserrat? — and the idea that this middling power with no domestic manufacturing could have done much better seems a little fantastical now.
So that’s not the problem either, because as Dr. Isaac Bogoch, an infectious diseases specialist and member of the province’s Vaccine Task Force put it, “you’re not going to vaccinate your way out of a third wave. You’re going to policy your way out of a third wave.”
“It’s in everybody’s interest to move the vaccine into the hot spots, and turn up the public health measures,” says Dr. Kevin Smith, the president and CEO of University Health Network. “We’re only going to regret what we don’t do at this point.”
And that right there is the problem. The problem is that Ontario charged right into a third wave that could smash out hospitals despite warnings from scientists and public health, and ICUs held a record 635 COVID-19 patients on Wednesday morning, and the seven-day average of new cases is over 4,000 a day in exponential growth, and as the Star’s Megan Ogilvie reports, doctors are being flown to the GTA from all over while GTA patients get choppered anywhere we can find a bed. The problem is over 72 hours from April 9 to 12, 69 COVID patients walked into Scarborough hospitals to be admitted, or nearly one an hour. Peel was likely similar, and maybe Humber, too. The variants are ravaging the province, and the bathtub keeps filling up.
The problem is every province from Quebec westward walked into the third wave like heedless children, and Ontario is likely heading for a minimum of 1,000 COVID patients in the ICU, an unthinkable number, and maybe 9,000 or 10,000 cases in a day, and even holding to that might require measures — paid sick days, travel restrictions, actually sending every non-essential worker home — that this government has, over and over, eschewed.
So the ORNGE helicopters keep flying, and the bathtub keeps filling up, and we keep swimming towards hell. And the problem is that because of governments that didn’t learn anything in the last year, we were never going to have enough vaccines in time to stop.
The problem is that Ontario charged right into a third wave that could smash out hospitals despite warnings from scientists