OT: Everything COVID19 - PART 8

[Knave]

Well, a good portion of the millions of doses of AstraZeneca vaccine will be coming into Canada on flights from India. So it's really difficult for the Govt to ban flights and not risk India just cutting off Canada. Although that might happen anyway now...

India stopped exporting back on March 24,2021 and re-opened for small donations to certain countries, some (not all) Covax exports. Our Covax doses were coming from South Korea so I doubt we'll get exports India will view as 'optional'. We got some earlier in a PR coup for their President. "Hey look at developing India helping rich Canada". But now India is suffering so there's no way we're getting anything.

I just don't think India will ever be a reliable supplier. We're relying entirely on the goodwill of Europe as the two other major places (America, India) have shut us out and put their citizens first. Maybe the US might be in a position to help us soon given they have opened up vaccinations to people 18+ and their rates of vaccination are falling.

 

[Billy Bridges]

My family history? both sides, is littered with heart issues....I carry heart attack as a middle name. You can imagine, my Nieces and Nephews are most likely susceptible...So, we ask them to increase their chances of heart issues, so that my 85 year mother is okay???? My Mother would not accept.

Having heart issues does not increase the risk of vaccine side effects. Having heart issues increases the risk of severe COVID.

 

[FunkySeeFunkyDoo]

Unfortunately that's simply not the case.

We could have slowed the spread if our only focus was on vaccinating as many people as we could, as quickly as possible. But that wouldn't be "fair", because young people in Toronto would have been vaccinated before 65 year olds in Sudbury. So we distributed vaccines based on age, and sent them to different regions. It added weeks to timelines. And now, we are where we are.

And let's stop chalking everything up to "people aren't careful enough".

There are specific policies that are our governments (at all levels, across all parties) have failed to put into place, that have had far more of an effect than any person's individual actions.

I think this is a bit revisionist.

Going back to Dec / Jan / Feb / Mar, the vaccine rollout was about LTC's and healthcare workers first, then the elderly, then the old... etc. And that was all about vaccinating the populations that were mosts susceptible to the disease AND (in particular) most likely to require hospitalization. IE, it was about keeping hospitals and ICUs under control, not about some notion of "fairness".

I think you'd be hard pressed to find people back in February who were disagreeing with that plan.

It's only more recently, last 3 or 4 weeks, where the variants have caused this 3rd wave that it's been obvious in hindsight that a better strategy would be as you describe.

I'd like to see them pivot faster to just vaccinating like crazy in some areas of Toronto. But I can imagine that they need to rethink alot of the logistics and therefore it's not as easy as you could imagine.

 

[FunkySeeFunkyDoo]

This is an interesting and oft overlooked point. It would have been most efficient and effective to simply vaccinate as many people as possible as quickly as possible, regardless of risk factors or age.

But that would have been bad PR. So we did things slowly to fit a preferable narrative.

See my last post. The notion that the vaccine rollout plan was due to optics or PR or whatever just simply doesn't line up with the (very recent) history.

 

[Big Muddy]

The other consideration is the allocation of resources.

Yes, we could mitigate risks from international travel by putting in place and enforcing strict guidelines. But that requires significant resources. Which means there are less resources available to help people who are living in Canada.

International travel from a hot-spot like India, in 95% of cases, is not essential. And it should not be allowed.

Let's say you get an incoming flight that has multiple cases, which has already happened quite frequently. That flight lands in Canada, and everyone is forced to quarantine. During that quarantine, a person develops significant complications and has to be admitted to the ICU. Right there, you've taken a bed that is no longer available for a person living in Canada.

I get what you are saying, especially as a concept.

But, people that have vaccinated do not have those same risks, and not everyone is coming from India. To be more specific on last point, some countries have made significant progress at vaccinating their populace. So, at least from the U.S. (Israel), you are already seeing numbers fall (deaths, hospitalizations, etc.) dramatically. From all the studies I've read, vaccinated people do not end up in ICUs, or hospitals. Couple that with the fact that these regulations have been implemented and are already in place, so yes, the emphasis has to be on enforcement. The government has hired third party companies to do this. As an example, you establish a video conference with these folks so they can watch you take the multiple tests that are required.

I think we'll see a day where change will be coming because the dynamic & factors have changed (for the positive). At least perhaps (hopefully not too far out in the future) it will for certain people, from specific countries, and particularly for Canadian citizens that have been vaccinated and are visiting a family member who is already vaccinated as well.

 

[Mingus Dew]

See my last post. The notion that the vaccine rollout plan was due to optics or PR or whatever just simply doesn't line up with the (very recent) history.

I think there were people calling for a mass vaccination (rather than targeted vaccination) strategy from the jump, although I could be jumbling timelines.

It's not like the virus's tendency to mutate was only discovered in the last few months.

So while I was being a bit hyperbolic, I do think there would have been a public outcry if the government prioritized vaccinating young people in major metro centers over the elderly in rural suburbs. I think it was a factor in the decision making.

 

[FunkySeeFunkyDoo]

I think there were people calling for a mass vaccination (rather than targeted vaccination) strategy from the jump, although I could be jumbling timelines.

I can imagine that is true, but I simply have not seen it. I read this board, I read the old HF Politics board, I read comments in various on-line news sites. Don't recall anyone back in Feb calling for a different strategy.

It's not like the virus's tendency to mutate was only discovered in the last few months.

So while I was being a bit hyperbolic, I do think there would have been a public outcry if the government prioritized vaccinated young people in major metro centers over the elderly in the rural suburbs. I think it was a factor in the decision making.

It is very true that the new variants existed were known (although characteristics likely not well understood) to exist back in Jan and Feb. And medical professionals were tracking their growth rate at that time and sounding the alarm bells.

But even knowing that they existed and might be more contagious back in Feb, does that necessarily point to a different strategy? I mean, I think it's reasonable of the health care officials in Feb to still view LTCs as the most vulnerable and that the new variants would just tear through them like wildfire.

 

[Big Muddy]

And if their "home" is not Canada, and they chose to stay in a country that's become a hotspot, they should not be allowed into the country at this point in time. Even if they're a citizen.

For our government, the needs of people in the country outweigh the needs of those abroad.

There are countries with different situations. Some are "hotspots", some are not. Some countries have a good segment of their population vaccinated already. I guess all I'm saying its not a one description or policy fits all situations.

I will say this, if we do a comparison and consider risk, lets consider the two scenarios (described below).

Scenario A

A Canadian citizen who has:

• Been fully vaccinated
• Is visiting an immediate family member who has been fully vaccinated
• Who is coming from a country with a high percentage of its population that have been vaccinated
• Who has been tested negative 3 three times in a 11-day span
• Who has quarantined for 14-days

Scenario B

Millions of citizens living in the country who:

• Have not been vaccinated
• Who have not been tested
• Who have not quarantined

Which of the two scenarios pose the biggest risk?

I'm going to guess that those in Scenario A pose a negligible risk, certainly much lower than those in Scenario B. I'm going to guess that most people familiar with risk management would agree (although experience in this discipline wouldn't be required to make that judgement).

And, once through the 14-day period, the Scenario A people have been vaccinated, so they still pose a much lower risk than those in Scenario B.

I think its emotions or something else that drives an unfocused view on this.

 

[Knave]

I can imagine that is true, but I simply have not seen it. I read this board, I read the old HF Politics board, I read comments in various on-line news sites. Don't recall anyone back in Feb calling for a different strategy.

No but our public health officials should know better.

Here's a short play by play when we go back and take a look:
- Toronto ICU occupancy was still very high in February and early March
- Cases plateaued at around 1K a day, again mostly in the GTA
- Public health officials, the science table repeatedly expressed concerns about growth of variants and the variants being more contagious
- Many GTA health officials decided to relax restrictions coming out of the December/January lockdown despite having a high baseline caseload, ICUs with high numbers of COVID-19 patients and the looming threat of variants which they acknowledged.

I'm not sure there is any other way to describe this other than a failure by public health officials (and the government) for not acting.

We do need an inquiry. Maybe we need a "GTA Public Health Unit" of higher rank than say Peel, York, Toronto, etc... so the region can be coordinated instead of some public health officers playing fast and loose with restrictions while others maintain stronger restrictions for months on end. I don't know. I'm not an expert but it seems like the experts all saw this disaster coming and public officials just watched instead of acting.

 

[DaveMatthew]

I think this is a bit revisionist.

Going back to Dec / Jan / Feb / Mar, the vaccine rollout was about LTC's and healthcare workers first, then the elderly, then the old... etc. And that was all about vaccinating the populations that were mosts susceptible to the disease AND (in particular) most likely to require hospitalization. IE, it was about keeping hospitals and ICUs under control, not about some notion of "fairness".

I think you'd be hard pressed to find people back in February who were disagreeing with that plan.

I don't think that's necessarily true. There were a lot scientists and public health experts who were quite vocal about how governments were missing the point, early on.

Michael Mina, a Professor of Epidemiology and Immunology at Harvard, has been beating a drum about it for a while now. He's talked a lot about how we shouldn't be trying to do what's best for a "group of individuals". Instead, we should be focused on what's best for the "entire group".

In normal times, a doctor thinks this way: I need to treat the person who's most at risk first (triage), and if I suspect there's something wrong, I need to give him the most accurate test I have to make a conclusion about the subsequent course of action.

Mina has said, "We must immediately stop attempting to solve a public health problem by focusing on it as a series of independent medical problems needing to be fixed. "

That's what we've done here, and it's prolonged this pandemic.

We relied on PCR tests, because they were the most accurate. Unfortunately, they also took the longest to get results.
We're vaccinating based on age and risk-factors, because those people are in the most danger. Unfortunately, getting vaccines to specific groups of people is much more difficult and takes much longer, and while we've tried to reach team, COVID is spreading exponentially.

Much has been written about this in terms of testing:

"Our big picture finding is that, when it comes to public health, it's better to have a less sensitive test with results today than a more sensitive one with results tomorrow," said study lead author Daniel Larremore from the University of Colorado at Boulder in the US. They found that when it came to curbing spread, the frequency and turnaround time are much more important than test sensitivity.

PCR test: Frequent, rapid testing can eliminate Covid-19 pandemic within weeks, says study - The Economic Times

It's a similar situation with vaccines.

As callous as it sounds, the goal is to stop the spread. Not save those who are most at-risk.

In the long-run, it's better to vaccinate more people with lower risk-factors today, then less people with higher risk-factors tomorrow.

 

[JD1]

Flights from India and Pakistan now banned

 

[FunkySeeFunkyDoo]

No but our public health officials should know better.

Here's a short play by play when we go back and take a look:
- Toronto ICU occupancy was still very high in February and early March
- Cases plateaued at around 1K a day, again mostly in the GTA
- Public health officials, the science table repeatedly expressed concerns about growth of variants and the variants being more contagious
- Many GTA health officials decided to relax restrictions coming out of the December/January lockdown despite having a high baseline caseload, ICUs with high numbers of COVID-19 patients and the looming threat of variants which they acknowledged.

I'm not sure there is any other way to describe this other than a failure by public health officials (and the government) for not acting.

We do need an inquiry. Maybe we need a "GTA Public Health Unit" of higher rank than say Peel, York, Toronto, etc... so the region can be coordinated instead of some public health officers playing fast and loose with restrictions while others maintain stronger restrictions for months on end. I don't know. I'm not an expert but it seems like the experts all saw this disaster coming and public officials just watched instead of acting.

Oh I wouldn't deny that they have screwed up. The results are what the results are -- we're in a 3rd wave that is far more serious than anything that's happened previously.

(And, as I've noted a few times on this board, my wife is somewhat obsessed with this whole topic and I can tell you on the evening in February that they announced the restrictions being relaxed she said to me "This is a big mistake. Those new variants are going to cause a third wave, and it's going to be bad." So, I can tell you I've been hearing about this for quite sometime now... )

I am just arguing that the vaccine strategy was never about "optics" or "fairness" or "catering to a demographic" or anything like that. They were simply targeting the group that they thought would be most likely to get the virus and most likely to need ICU beds.

It was always about what they thought was the best way to protect the healthcare system.

They were wrong though, obviously.

 

[Mingus Dew]

I don't think that's necessarily true. There were a lot scientists and public health experts who were quite vocal about how governments were missing the point, early on.

Michael Mina, a Professor of Epidemiology and Immunology at Harvard, has been beating a drum about it for a while now. He's talked a lot about how we shouldn't be trying to do what's best for a "group of individuals". Instead, we should be focused on what's best for the "entire group".

In normal times, a doctor thinks this way: I need to treat the person who's most at risk first (triage), and if I suspect there's something wrong, I need to give him the most accurate test I have to make a conclusion about the subsequent course of action.

Mina has said, "We must immediately stop attempting to solve a public health problem by focusing on it as a series of independent medical problems needing to be fixed. "

That's what we've done here, and it's prolonged this pandemic.

We relied on PCR tests, because they were the most accurate. Unfortunately, they also took the longest to get results.
We're vaccinating based on age and risk-factors, because those people are in the most danger. Unfortunately, getting vaccines to specific groups of people is much more difficult and takes much longer, and while we've tried to reach team, COVID is spreading exponentially.

Much has been written about this in terms of testing:



PCR test: Frequent, rapid testing can eliminate Covid-19 pandemic within weeks, says study - The Economic Times

It's a similar situation with vaccines.

As callous as it sounds, the goal is to stop the spread. Not save those who are most at-risk.

In the long-run, it's better to vaccinate more people with lower risk-factors today, then less people with higher risk-factors tomorrow.

Spot on and much more eloquent than anything I can muster.

 

[coladin]

The other consideration is the allocation of resources.

Yes, we could mitigate risks from international travel by putting in place and enforcing strict guidelines. But that requires significant resources. Which means there are less resources available to help people who are living in Canada.

International travel from a hot-spot like India, in 95% of cases, is not essential. And it should not be allowed.

Let's say you get an incoming flight that has multiple cases, which has already happened quite frequently. That flight lands in Canada, and everyone is forced to quarantine. During that quarantine, a person develops significant complications and has to be admitted to the ICU. Right there, you've taken a bed that is no longer available for a person living in Canada.

Easiest thing to do is quarantine all passengers from India for the full 14 days. It has to be done.

 

[Do Make Say Think]

Unfortunately that's simply not the case.

We could have slowed the spread if our only focus was on vaccinating as many people as we could, as quickly as possible. But that wouldn't be "fair", because young people in Toronto would have been vaccinated before 65 year olds in Sudbury. So we distributed vaccines based on age, and sent them to different regions. It added weeks to timelines. And now, we are where we are.

And let's stop chalking everything up to "people aren't careful enough".

There are specific policies that are our governments (at all levels, across all parties) have failed to put into place, that have had far more of an effect than any person's individual actions.

EDIT: the reason governments failed is because the general populace is weak.

 

[Tuna99]

I’m a 38 year Sens fan living in Toronto and I called to get a vaccine:

Clinic “we aren’t giving vaccines to 38 year olds sir without....”
“I have chronic illness”
“Which one”
“Im a life long Sens fan”
Long pause
“Please hold”
I held for like 17 minutes and when he came back he said:
“I checked your illness and it was a grey area but the doctor says you qualify and can come in”

true story, got my shot. Doctor was a Leafs fan, they told me the doctor joked I must be the only sensible Sens fan in Toronto to know I had a chronic disease and he qualified me on a rare disease list

being a Sens fan can save your life

 

[Here I Pageau Again]

I’m a 38 year Sens fan living in Toronto and I called to get a vaccine:

Clinic “we aren’t giving vaccines to 38 year olds sir without....”
“I have chronic illness”
“Which one”
“Im a life long Sens fan”
Long pause
“Please hold”
I held for like 17 minutes and when he came back he said:
“I checked your illness and it was a grey area but the doctor says you qualify and can come in”

true story, got my shot. Doctor was a Leafs fan, they told me the doctor joked I must be the only sensible Sens fan in Toronto to know I had a chronic disease and he qualified me on a rare disease list

being a Sens fan can save your life

I do badly hope this is so true!!

And I gotta say, props to the 40-50 year olds jumping at the opportunity at getting vaccinated.

On an ICU note... CHEO is also going to take adult COVID patients.

CHEO prepares to accept local, young adults requiring critical care

 

[FormentonTheFuture]

I’m a 38 year Sens fan living in Toronto and I called to get a vaccine:

Clinic “we aren’t giving vaccines to 38 year olds sir without....”
“I have chronic illness”
“Which one”
“Im a life long Sens fan”
Long pause
“Please hold”
I held for like 17 minutes and when he came back he said:
“I checked your illness and it was a grey area but the doctor says you qualify and can come in”

true story, got my shot. Doctor was a Leafs fan, they told me the doctor joked I must be the only sensible Sens fan in Toronto to know I had a chronic disease and he qualified me on a rare disease list

being a Sens fan can save your life

Yeah that happened...

 

[Nac Mac Feegle]

Flights from India and Pakistan now banned

I'm glad. Canada has been way too soft internationally. I understand why we are, but it hasn't helped us as a nation. It's not taking a stand for the right way for civilization to act when we're the only country doing it. Everyone else has been playing "my country first"...and we csimply can't fight that.

If we do anything after this pandemic, we need to get a few labs and medical manufacturing and distribution centers built int he country. Relying on other in a global pandemic is a recipe for failure. EVERYONE is going to prioritize their own nation...it's human nature. We need to start thinking pragmatically and do the same.




As for the vaxx rollout.....we could've done both. Half the vaccine goes to the senior crowd, and the other half first come first serve (with a heavy lean toward first responders and front line folks to start). That way, you have a good focus on seniors, while also getting an early start on the general population. It never had to be one or the other.

 

[Sens of Anarchy]

more in the thread

 

[foggyvisor]

more in the thread

Yup. We would crucify our own government if they exported vaccines during the peak of our pandemic. India needs them more than we do.

I fully expect us to buy AZ vaccines from the US since they are stocked but have yet to approve it. Biden finally took Trudeau's call on vaccine help, so it seems like a slam dunk from here on out.

Trials have started on mixing vaccine doses. It could have immunity advantages and would also afford extra flexibility to help governments administer second doses. Don't be surprised to see people getting doses of Pfizer and AZ.

 

[DJB]

I'm glad. Canada has been way too soft internationally. I understand why we are, but it hasn't helped us as a nation. It's not taking a stand for the right way for civilization to act when we're the only country doing it. Everyone else has been playing "my country first"...and we csimply can't fight that.

If we do anything after this pandemic, we need to get a few labs and medical manufacturing and distribution centers built int he country. Relying on other in a global pandemic is a recipe for failure. EVERYONE is going to prioritize their own nation...it's human nature. We need to start thinking pragmatically and do the same.




As for the vaxx rollout.....we could've done both. Half the vaccine goes to the senior crowd, and the other half first come first serve (with a heavy lean toward first responders and front line folks to start). That way, you have a good focus on seniors, while also getting an early start on the general population. It never had to be one or the other.

It took about 14 months too long to close the borders...

 

[Sens of Anarchy]

There have been quite a few people whining about any kind of closures or shut downs all along the way. There was always only one way to curtail this thing.. And it came at a cost for people and governments, neither seemed to have the will for it.

 

[Nac Mac Feegle]

It took about 14 months too long to close the borders...

Yes, they are too late.

But I'd rather too late than never. Especially now with variants appearing faster than lost family members after a lotto win.

 

[Do Make Say Think]

more in the thread

This is unfortunate news.

Hard to blame countries restricting export of vaccines though, I'd expect us to do the same until we had enough for ourselves.

It definitely sounds like the situation in India is ***** and that isn't great in terms of giving the virus opportunities to mutate.

We've been lucky that none of the mutations we've seen so far have invalidated the vaccines. Maybe this virus doesn't mutate well but I'd rather not try our luck...