Science

Thursday July 8, 2021

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Thursday July 8, 2021

First-dose COVID-19 vaccinations plateau across Canada, threatening path to variant resilience

The number of people getting their first COVID-19 vaccine doses is plateauing across the country, heightening the need to target harder-to-reach groups if Canada is going to achieve the vaccination levels needed to control the spread of infection.

May 22, 2021

As of Monday, 78 per cent of those eligible to be vaccinated in Canada have received at least one dose, and 41 per cent were fully vaccinated, making the country one of the most immunized in the world. Among the Group of Seven nations, Canada ranks second next to Britain with the highest number of doses administered per 100 people.

However, within provinces and territories, there are pockets with low vaccination rates across the country.

In the High Level health unit in northern Alberta, for example, 21 per cent of the eligible population had received at least one dose, and in Manitoba, 19 per cent of the eligible population in the municipality of Stanley had received at least one dose.

While the number of people receiving second doses continues to climb, those receiving their first doses have stalled at fewer than 100,000 a day since June 20.

January 30, 2021

With the rise of more transmissible variants, some epidemiologists estimate at least 80 per cent to 90 per cent of the eligible population will need to be fully vaccinated to keep COVID-19 rates under control.

Reaching those levels will be critical as we head into the fall, when people start spending more time indoors again at the same time the highly infectious Delta variant is expected to become the dominant variant of the virus in most of the country, said Cordell Neudorf, professor in the department of community health and epidemiology at the University of Saskatchewan.

“That’s when we expect the next wave to hit, unless we get high enough immunization coverage,” Dr. Neudorf said.

December 11, 2020

Now that those most willing and able to get immunized have received at least one vaccine, health authorities must ramp up their efforts to vaccinate groups that are more difficult to reach, said Nazeem Muhajarine, an epidemiologist and professor of community health and epidemiology at the University of Saskatchewan.

And that will require different targeted approaches, he said, since those who remain unvaccinated are a heterogenous group. They include people who are willing to be vaccinated but have difficulty accessing clinics, individuals who have lingering questions about the safety of vaccines and those who refuse to be vaccinated altogether.

May 8, 2021

The latter, whose refusal is generally ideologically driven, are a minority, making up an estimated 10 per cent of the population, Dr. Muhajarine said. Another 12 per cent to 14 per cent of Saskatchewan adults he has been tracking say they are hesitant about getting vaccinated.

“It’s the hesitant group that we need to be able to convert get a vaccine,” he said. “They’re not saying they would not get one, but they’re also saying they will not readily line up, be the first in line.” (Globe & Mail) 

 

Thursday June 17, 2021

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Thursday June 17, 2021

Think bigger, and smaller, than a vaccine lottery

The percentage of Canadians who’ve had their first shot of COVID-19 vaccine has rocketed this country to the top of the global charts. Yet even as Canada pivots to focusing on second doses, one-quarter of Canadian adults and teens have still not taken their first shot.

December 11, 2020

Could a lottery get them to stretch out their arms?

Last month, Ohio decided to try that approach. It’s part populism, part behavioural science. 

On May 12, the governor announced that the vaccinated would be entered into a draw, with a US$1-million prize awarded weekly, for five weeks.

The behavioural science insight behind all of this is that the human brain tends to misjudge probabilities. It’s why lotteries, with their poor odds – Ohio’s grand-prize odds are roughly one in a million – are often referred to as a tax on stupidity. Ohio decided to try to harness that stupidity for a good cause, namely boosting the vaccination rate. Several other states followed its lead, as have Manitoba and Alberta.

So how are things working out?

October 27, 2006

Thanks at least in part to Vax-a-Million, Ohio’s low vaccination rate did rise – but only for a short time.

In the seven days up to and including May 12 – the day the lottery was announced – the state of nearly 12 million people administered fewer than 92,000 first shots, according to our calculations from data on Ohio’s vaccine dashboard. The next week, after the lottery launched, first-shot vaccinations more than doubled.

The following week, however, vaccinations dropped by about a quarter. The next week, they dropped by almost half. The following week, they fell some more; the week after that, they fell sharply again.

And over the five days to June 14, Ohio averaged about half as many first shots as in the five days leading up to the lottery launch.

Ohio, which has now given a first dose to 47 per cent of its population, needed to up its rate by as much as 20 percentage points. Vax-a-Million appears to have delivered a boost of perhaps two percentage points, at most.

April 8, 2008

So far, Alberta’s lotto results are even less promising. Premier Jason Kenney announced the lottery plan 

on Saturday; on Sunday, Alberta recorded its lowest number of first shots since February. Monday’s tally was the second lowest since February. Tuesday was even lower.

There are many reasons why a quarter of eligible Canadians are still not vaccinated. The lack of pandemic prizes is likely the least of it. (Globe & Mail) 

 

Wednesday May 6, 2021

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Thursday May 6, 2021

NACI is right about AstraZeneca. It shouldn’t be ‘unsettling’ to trust the public with uncomfortable information

The National Advisory Committee on Immunization is being pilloried for asserting that, while taking the AstraZeneca and Johnson & Johnson vaccine is still generally a good idea, their higher risk for blood clots means that certain Canadians would be better served by waiting for a Pfizer or Moderna vaccine.

December 11, 2020

Despite high-level accusations that the message is “misleading” or even “dangerous,” NACI is right: Different vaccines obviously carry different risks, and it would be irresponsible not to weigh those risks against the risk of contracting COVID-19. The only reason NACI’s messaging sounds “mixed” or “unsettling” is because Canadian public health authorities have spent this pandemic strenuously avoiding nuance or even the basic notion that the public can be trusted with uncomfortable information.

The controversy began over NACI’s latest vaccine recommendations saying that they “preferentially recommend” mRNA vaccines such as the Pfizer and Moderna shots. NACI drew the distinction because of emerging data showing that, in rare instances, viral vector vaccines such as AstraZeneca and Johnson & Johnson can potentially pose a risk of blood clots. On Tuesday night, for instance, Alberta confirmed the death of a woman in her 50s due to complications from the AstraZeneca vaccine.

For most Canadians, the life-saving benefits of COVID immunity clearly outstrip any blood clotting risks posed by a viral vector shot. Nevertheless, while NACI said that Canada should continue to roll out as many vaccines as quickly as possible, there may be instances, particularly among young people, in which it’s preferable to sit out the immediate prospect of an AstraZeneca shot in favour of a Pfizer shot down the road.

January 30, 2021

“NACI cautions that in age groups younger than 30 years of age, the benefit of offering a viral vector COVID-19 vaccine instead of waiting for an mRNA vaccine is not a certainty, especially in areas of very low COVID-19 activity,” reads the new recommendations, which also say that “an mRNA COVID-19 vaccine should be preferentially offered to individuals” over 30 unless they prefer to get vaccinated earlier.

David Naylor, a co-chair of the COVID-19 Immunity Task Force, told CBC on Tuesday morning that it was an “unsettling” message because it “suggests that you got the second-best vaccine.” Infectious disease specialist Abdu Sharkawy tweeted that it was “dangerous” to imply “vaccine superiority.”

While many public health agencies have been free to take a single-minded focus on COVID-19 prevention to the exclusion of other health considerations, NACI’s mission has always been to maximize the benefits of immunization while weighing its potential harms. In NACI’s own words, their mission is to assess “how best to use authorized vaccines to achieve the greatest public health benefits.”

March 31, 2021

Over the last 13 months, Canada has gotten used to public health authorities prescribing blunt pandemic restrictions with little to no explanation as to why. Seldom has a chief medical officer ever gone on TV to explain the latest science on outdoor transmission and then asked their citizens to decide for themselves if a BBQ with friends is worth the risk.

NACI’s approach is different. Rather than follow Ottawa’s line to “take whatever vaccine is offered to you first”, they told the truth: Despite mass immunization being the single most effective way to save lives and end this pandemic, it doesn’t mean every AstraZeneca shot is a good idea.

In saying this, NACI didn’t issue an unequivocal “yay” or “nay” on the safety of AstraZeneca, they instead drafted a detailed risk-assessment to allow the public to figure out for themselves if AstraZeneca now is preferable to Pfizer later. You’re middle-aged and living in a hard-hit area with overwhelmed hospitals? Take the shot. You’re 21, living in Prince Edward Island and you barely leave the house? It might be worth waiting for Pfizer or Moderna.

December 1, 2020

NACI is certainly not an antivax organization. The group is composed of volunteer medical experts who have spent decades studying effective immunization. It was NACI who was instrumental in recommending the four-month gap between vaccine doses that has allowed Canada to maximize its limited supply and significantly push forward the national timeline towards herd immunity.

In a pandemic that has repeatedly seen politicians urge the public to “listen to the science,” NACI is the Platonic ideal of career scientists making recommendations without worrying about political narratives.

And yet, Prime Minister Justin Trudeau is now openly telling Canadians to ignore the NACI recommendation and take the first shot they are offered.

New Brunswick education minister Dominic Cardy took it a step farther, telling his constituents Tuesday to “ignore NACI, ignore anti-masker, ignore the people undermining the faith in science.” (National Post) 

 

Wednesday April 21, 2021

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Wednesday April 21, 2021

Will Doug Ford meet the same fate as Mike Harris?

Conservative politicians are sometimes suspicious of advice coming from experts for good reason: The experts just want them to not be conservatives.

But sometimes, their suspicions cause them to ignore good advice. This may have led Ontario Premier Doug Ford to take actions that could doom his government. If so, it won’t be the first time.

July 4, 2001

Former premier Mike Harris’s determination to keep cutting regulations, despite the warnings of experts, contributed to the deaths of seven people in the town of Walkerton, and to the Progressive Conservatives’s defeat at the next election. Mr. Ford may face the same fate, and for the same reason.

In May, 2000, Walkerton’s municipal water supply was contaminated by E. coli bacteria. Along with the deaths, more than 2,300 fell ill, some severely.

A public inquiry led by Justice Dennis O’Connor concluded that the public utilities manager, Stan Koebel, caused the contamination through his own incompetence, and then tried to cover up his misdeeds when people started getting sick. He was eventually sentenced to a year in jail.

The inquiry also concluded that the Harris government had contributed to the disaster. The ministry of the environment was no longer able to properly monitor municipal water supplies because of cuts to its budget and changes in regulations.

“If the MOE had adequately fulfilled its regulatory and oversight role, the tragedy in Walkerton would have been prevented … or at least significantly reduced in scope,” Justice O’Connor concluded.

Common Sense Revolution, 1995

The public had broadly supported the Harris government’s Common Sense Revolution, which slashed taxes, spending and red tape, while balancing the budget.

But people expect government to protect public health. Experts warned that spending cuts, deregulation and privatization had gone too far, endangering public safety, and Walkerton proved the experts right. In 2002, Mr. Harris stepped down as leader; his successor, Ernie Eves, led the PCs to defeat. The Tories remained in the wilderness for 15 years.

January 17, 2019

Since the pandemic began more than a year ago, Mr. Ford has sought to balance the needs of workers and businesses alongside the recommendations of public health and medical officials, an approach that until recently earned strong public approval.

But in the winter, the government appeared to lose that balance. A number of public-health officials and medical specialists warned that a third wave of COVID-19 infections, fuelled by more infectious variants of the virus, could slam into the province unless the government kept tight restrictions in place. Seeking to preserve jobs and personal freedom, the government instead relaxed restrictions. Now, we’re in the thick of it.

September 5, 2020

Last week, with the case counts rising and ICUs approaching capacity, the Ford government appeared to panic. The Premier on Friday announced a series of unpopular and seemingly counterproductive measures, such as banning outdoor gatherings, where risk of transmission is known to be lower, while permitting some indoor workplaces to remain open, where risk is higher. All of this was accompanied by draconian warnings that police could stop and fine people who ventured outside their home without sufficient cause.

Reaction was so intense – even strong Progressive Conservative supporters were appalled by what appeared to be arbitrary and perverse regulations – that the government was forced to back down on some measures within a day. Now, critics are calling for Mr. Ford’s resignation.

Conservative governments often arrive in power with a mandate from voters to root out vested and wasteful interests, both within and outside of government.

The hard part comes with the transition from the reform phase to the steady-government phase. Some conservative politicians manage that transition: Stephen Harper, federally; Brad Wall in Saskatchewan; Gordon Campbell (a Liberal who was really a conservative) in British Columbia.

Young Doug Ford: The Series

Other conservative politicians fail to mediate the conflicts between rural and urban members of caucus. They cut past the fat, into muscle and bone; their skepticism of elites blinds them to advice they should be taking.

The Ford government’s problems are not unique: Outside Atlantic Canada, infection rates have been rising across the country. Vaccination levels are rising, too, and may eventually beat back this third wave. The next election is more than a year away. The Premier and his government may get through this.

Or Doug Ford may meet the same fate as Mike Harris. If so, the third wave will be his Walkerton. (Globe & Mail) 

 

Saturday January 30, 2021

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Saturday January 30, 2021

Fauci calls South Africa-based variant’s resilience a ‘wake-up call.’

Dr. Anthony S. Fauci warned Friday that new clinical trial results from Johnson & Johnson, showing that its vaccine is less effective against a highly infectious variant of the coronavirus circulating in South Africa, were a “wake-up call.” He said the virus will continue to mutate, and vaccine manufacturers will have to be “nimble to be able to adjust readily” to reformulating the vaccines if needed.

March 26, 2020

Dr. Fauci’s warning, at the White House briefing on the virus, comes amid increasing concern about new and more infectious variants of the virus that are emerging overseas and turning up in the United States. This week, officials in South Carolina reported identifying two cases of the variant circulating in South Africa, and officials in Minnesota announced they had found a case of the variant that was first detected in Brazil.

Dr. Rochelle Walensky, the new director of the Centers for Disease Control and Prevention, who was also at the briefing, said another variant, first identified in Britain, has now been confirmed in 379 cases in 29 states. 

She said officials remained concerned about the variants and were “rapidly ramping up surveillance and sequencing activities” to closely monitor them. Unlike Britain, the United States has been conducting little of the genomic sequencing necessary to track the spread of the variants.

August 6, 2020

Dr. Walensky also issued a plea to Americans to continue wearing masks and practice social distancing, and to avoid travel. Earlier this month, the C.D.C. warned that the variant circulating in Britain could become the dominant source of infection in the United States and would likely lead to a surge in cases and deaths that could overwhelm hospitals. And given the speed at which the variant swept through that country, it is conceivable that by April it could make up a large fraction of infections in the United States.

December 11, 2020

“By the time someone has symptoms, gets a test, has a positive result and we get the sequence, our opportunity for doing real case control and contact tracing is largely gone,” she said. “We should be treating every case as if it’s a variant during this pandemic right now.”

Friday’s briefing, the second in what the Biden White House has promised will be thrice-weekly updates on the pandemic, came just hours after Johnson & Johnson reported that while its vaccine was 72 percent effective in the United States, the efficacy rate was just 57 percent in South Africa, where a variant has been spreading. (New York Times)