By Ian Pattison
This is an updated version of a column that first appeared Dec. 19 in the print edition and on the website.
Canada is confused. We are a country in doubt and denial. Doubt over a vaccine we are, ironically, desperate for, and denial among some governments to act decisively enough to ward off that which is killing Canadians at a new and frightening pace.
Doubts about a series of vaccines that have been developed in record time is understandable. How can we be sure they are safe when it usually takes as much as a decade to move from discovery research and pre-clinical stages followed by phase 1 to 3 clinical trials and finally regulatory review and approval?
In fact, we’ve had that long to model the vaccines that Pfizer, Moderna and others have developed. The preparations began with the SARS and MERS coronavirus outbreaks, laying the scientific groundwork to use next-generation genetic mapping to target COVID, which is technically called SARS-CoV-2.
The massive outbreak of COVID cases, while unfortunate, gave scientists a vast array of test subjects and meant they didn’t have to wait long to see if the shots they gave appeared to be working.
Billions of public and private dollars were invested in the process as COVID ravaged country after country. Steps that normally are taken in succession, each requiring separate approvals often at political whims, have been taken simultaneously since COVID-19 sprang on us a year ago.
Now, in an unprecedented global effort, we have two vaccines with 95-per-cent effectiveness delivered and in use in less than a year. More are on the way.
There have been isolated reports of adverse reactions to shots administered this week, prompting doubts about something so new to turn to fear among some people. But the regular flu shot produces the same sort of thing among those who are prone to certain allergic reactions. The drug makers issued warnings to those same people to avoid taking this new vaccine. This was not unexpected and is not cause for undue concern.
What is potentially concerning is the emergence of a mutation of COVID in the south of England over the past week. Viruses mutate all the time. It doesn’t mean this strain is more transmissible or more infectious. It can be detected by swabs and U.K. scientists are in high gear to assess whether the behaviour of this version has changed. According to the health secretary, there is "nothing to suggest" it caused worse disease or that vaccines will no longer work.
Fear-mongering among the anti-vaxx movement has instilled irrational doubts about any vaccine in a segment of the population. But consider smallpox as just one example of the success of vaccines.
During the 20th century, smallpox was responsible for 300–500 million deaths. As recently as 1967, the World Health Organization estimated that 15 million people contracted the disease and that two million died. With a 30-per-cent fatality rate, smallpox has been completely eradicated worldwide by use of vaccination. As a result, many people born after the Baby Boom are totally unfamiliar with the fear caused by outbreaks of smallpox and the horrible scarring among survivors.
Vaccines against the polio virus, measles, mumps, diphtheria, tetanus and others, have prevented deaths and permanent disability in children globally. Influenza vaccines save untold numbers of lives annually, especially among the elderly at higher risk of disease.
Still, use of the COVID vaccines will face an uphill fight to gain public confidence and acceptance. They’re new, they’re different, they go into our bodies and we have to trust people we don’t know that we won’t suffer some unforeseen bad reaction.
We get it. But as more people in the first cohort of recipients tell their stories, confidence will invariably grow as the vaccine rollouts continue. Public influencers, in politics, entertainment and sport will be important messengers. Even Mike Pence got the shot.
Those who’ve received an injection so far tell of typical pain at the site, chills and a mild fever. Like the annual flu shot, those symptoms are usually gone within a couple of days. And boom, you’re producing antibodies.
One man in Brooklyn who enrolled in a Pfizer trial earlier this year said recently he has had no long-term symptoms six months later. "None," he said. "Nothing after 48 hours."
Confidence will come as public measures show success. It’s too bad that Canada is averse to a national approach to this national health crisis. We’ve got a national medicare plan in name only. Each province takes its own approach, using federal dollars with its own to attack the virus with varying degrees of success.
Ontario is a prime example of a failed strategy. Cases, hospitalizations and deaths have been climbing for weeks and raging in recent days across the south. The government squandered a summer of virus slowdown in which it could have developed a precise, widespread contact tracing and rapid testing regime that would have prevented the second wave we now face.
A variety of Toronto media outlets reported Sunday that Premier Doug Ford will place the entire province in the grey lockdown stage on Christmas Eve. Apparently restrictions will last 14 days in Northern Ontario, 28 days in the south. Northerners will be wondering why they are lumped in with regions south of Sudbury where all COVID indicators are much higher.
The timing is typical of this government. Signal further restrictions are coming, ensuring a mad rush to buy presents, then tell everyone they can’t get together to exchange them. People were prepared to follow new restrictions beginning on Boxing Day as reported over the past week.
The Thunder Bay region recently flirted with startling increases until this week when it appeared things had stabilized -- 103 cases Sunday with none hospitalized but, sadly, 15 deaths, mostly in a for-profit Southbridge long-term care home which has seen more than 100 positive test results. Two staff members at a second Southbridge home in Thunder Bay have now acquired COVID with an employee at the city-run Pioneer Ridge testing positive on Saturday.
CBC Marketplace found that Southbridge has the highest death-rate per 100 beds among long-term care homes in Ontario -- nine compared with an average 3.75 across all homes. Municipal and non-profit homes consistently have lower death rates than their for-profit counterparts.
Long before COVID-19 arrived, there were more transfers to hospitals, more deaths and more bed ulcers in for-profit homes, one source told Marketplace.
All homes need more staff, said Pat Armstrong, a professor at York University who studies best practices in long-term care, but it's "particularly the case in the for-profits."
Standards of health care are supposed to be, well, standard in this country. Profiting off substandard care should not be acceptable.
COVID records in southern Ontario were shattered on successive days this week as Premier Doug Ford continued to insist he takes his lead from health care personnel. Doctor and hospital associations say different; they’ve been urging him to get serious for more than a week but it wasn’t until Friday that he met with his cabinet to consider locking down the south from Boxing Day until Jan. 11. An emergency weekend meeting with various authorities has apparently resulted in the new, tougher, province-wide schedule.
In the coming holidays we can almost certainly expect a further surge in infections as friends and families, exhausted by separation and desperate for love and fellowship, take chances with their health and, ultimately, that of their communities. The lockdown is intended to mitigate that. Will it be enough and did the government wait too long to impose it?
In the meantime, we can take heart in the secure knowledge that vaccines are now with us. Our regional hospital is scheduled to receive a batch of the Pfizer vaccine by the end of the year and has reportedly already secured and installed the required super-cold storage freezer.
We’ve got this, as long as we continue to be patient and careful. Please have a safe Christmas, and an extra-merry one in 2021.
Ian Pattison is retired as editorial page editor of The Chronicle-Journal, but still shares his thoughts on current affairs.