Front Burner - Canada’s slow drip vaccine rollout

Episode Date: January 8, 2021

Canada has received more than 430,000 doses of the COVID-19 vaccine. But as of Thursday, only about 45 per cent of those doses have gone into arms. Those numbers are sourced from the COVID-19 Canada Open Data Working Group, made up of public health experts and data scientists from the University of Toronto and the University of Guelph. Provincial governments across the country have been roundly criticized for not administering the vaccines they got in mid December quickly enough. Today on Front Burner, Globe and Mail health columnist André Picard and scientist Krishana Sankar, on why the rollout has been so challenging and what can be done about it.

In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. This is a CBC Podcast. Hello, I'm Jamie Poisson. So far, Canada has received more than 430,000 doses of the COVID-19 vaccine. And as of Thursday, only about 45% of those doses have actually gone into arms. Those numbers are sourced from the COVID-19 Canada Open Data Working Group, made up of public health experts and data scientists from the

University of Toronto and the University of Guelph. Governments across the country have been roundly criticized for not deploying the vaccines they started to get in mid-December quickly enough. Prime Minister Justin Trudeau said this about the slow rollout on Tuesday. I think all Canadians, including me, are frustrated to see vaccines in freezers and not in people's arms. That's why we're going to continue working closely with the provinces, both to deliver vaccines to the provinces and to support them as they need it in terms of getting more vaccines out to vulnerable populations and frontline workers as quickly as possible. All of this is happening as Ontario reported a record-breaking case count on Thursday, more than 3,500 cases. And Quebec prepares to enforce an overnight curfew starting Saturday to slow the spread of COVID-19.

Today, I've got two guests with me who've been watching the vaccine roll out closely. Globe and Mail health columnist André Picard and Krishana Sankar, a scientist who works with COVID-19 resources in Canada, which helps health professionals access information. This is FrontBurner. Hello to you both. Thank you so much for coming on to the show today. Hi, Jamie. Hi, Jamie.

So before we talk about the vaccine rollout, I just want to note how it works here. So essentially, the federal government is delivering the vaccine to distribution centers across the country. And Andre, big picture here against a global backdrop. How would you characterize the job that Canada is doing? Well, I think big picture, it's a middling job. We've been very slow to vaccinate to use the stock that we have. And the other part of the equation is we didn't, we don't have very much stock now. So it's kind of a doubled barrel problem. But we're doing much worse than many countries in the world, unfortunately. Krishana, we hear governments at various levels say that the Pfizer and Moderna vaccines have been hard to transport because they need to be stored at colder temperatures between negative 80 and negative 60 degrees. But other countries, other states in the U.S., they made it work, right? And do you

think that the logistical challenges around transporting the vaccine really explain this slow rollout here? One of the major challenges was definitely the transport of the vaccine, considering the temperature, especially that the Pfizer vaccine needs to be kept at. However, if we look at even just some of our own provinces, one of the strategies that they took was to actually have the vaccine administration sites in long-term care facilities. And that's one of the first places that really needed the vaccine right now during our Canadian rollout. Quebec will receive 4,000 vaccine doses in the coming days. Maimonides Geriatric Centre, which has already recorded dozens of deaths, is at the very top of the list. It's going to make a big difference.

We did not have that happen here in Ontario. However, I did see recently that in Ottawa, there's a pilot project where the Pfizer vaccine will be rolled out to or transported to long-term care facilities so we can have some vaccine administration happening in those facilities. Andre, it does seem like, and please correct me if I'm wrong here, but it seems like the focus in Canada has largely been on hospital sites delivering the vaccine. And does that need to change? Yeah, Canada has really done most of its vaccination in hospitals, rather than long-term care homes. There's been some of that around the country, but that's really been the focus. I think that's just largely a reflection of our system. Our system is very hospital-centric overall, and so it's not too

surprising it happened like that. Should it be like that? Probably not. You know, public health has a history of doing mass vaccination, and they should probably be in charge of this rather than hospitals. And the real problem, I think, is not the sites, etc. I think the problem was one of politics. There just seemed to be a lack of political will, a lack of urgency in this. And I just don't understand why that was the case. Andre, talking about public health and their history with mass vaccinations, I'm thinking about New York here as well. I know in New York, county officials are angry. They're saying that years of planning for mass vaccinations using local public health departments is essentially

being pushed aside by the administration of Governor Andrew Cuomo, who's retained control of the vaccination program. And like what's happening here is having hospitals administer it. And why, though, is that happening? Why are we not leaning on public health on these institutions that have histories doing this? Yes, our public health does have quite a glorious history of vaccination. It goes back to polio, these mass campaigns of polio vaccination. Even when we look at pandemic influenza H1N1 in 2009, we were doing more than a million vaccines a week, and this was all done by public health. So you have a good question. Why isn't it being done like this? There's no question public health is hurting.

They've been cut a lot over the years, but can they do it? I think they have the ability to do it. Maybe we could have done this differently with volunteers. Many healthcare workers, when we heard that the clinics were shut down, said, that's crazy. We'll volunteer. We'll volunteer day and night. Just tell us. And again, I don't think, I don't understand why the call wasn't pulled out. Why didn't we tap into the resources we have? And I just want to be clear here when we're talking about public health, like what are

we talking about? Is this your family doctor? Is this your pharmacy? Well, in this case, I think vaccines down the road may be able to be done by family docs and pharmacists, but we can't with these very technical vaccines that need to be kept in ultra cold freezers. We have to do them at some centralized location. But the question is, who is going to put those shots into your arm? So it can be a family doc. It can be a pharmacist.

It can be a paramedic, a public health nurse. There's any number of people who are qualified to do this. a paramedic, a public health nurse. There's any number of people who are qualified to do this. And all we have to do is, as many countries around the world has done, is set up clinics, set up a structure, and then get the people there and they're more than happy and more than qualified to do it. Krishana, who else could be doing this? You know, I was thinking of medical students. I know people have been talking about the possibility of training medical students and in California, they seem to be allowing dentists to start administering the vaccine. I think even before we go and reach into students, whether they're medical students or nursing students doing this, is even giving the access to the people who are already licensed and qualified

to do it and giving them the access to do this within whether it be the hospital settings and removing issues around privilege and red tape. So some of my healthcare professional colleagues have mentioned, you know, reaching out to hospitals and saying that they would want to, they would like to volunteer, but being given a lot of red tape around whether or not they can actually assist in administering vaccines. And I think that's a huge issue right now, especially when there are so many who are willing and ready to do this. But when it comes to bureaucracy, having that sort of structure in place that hinders instead of helps with vaccine administration is an issue. So beyond that, having students being able to teach and train medical students and nursing students to do this is a great option.

But I think we already have a vast resource in the current health care professionals who are qualified and licensed, but are just not being able to help with the administration of these vaccines. I want to look outside of our borders and talk about what other countries are doing. So as of January 7th, Canada had vaccinated about a half of a percent of our population. And so, you know, as Andre, you were talking about at the beginning of this conversation, sort of this middling response. We're currently around 10th in the global race, even though we were one of the first countries to approve the vaccine. But I want to talk about Israel, because they have managed to vaccinate 17% of their population, about 1.5 million people. And Andre, what exactly is Israel doing

differently here? Well, I think Israel has been held up as an example because they did everything right. So what did they do? They ordered early. Canada ordered quite late its vaccines. They paid handsomely for their vaccines, so they were willing to pay a premium to ensure they'd get a lot of supply early. It's a very organized health system. Israel has an excellent public universal healthcare system. It's the core HMOs that administer the whole country. So super organized. And I think they just made it a political priority. They said, we're going to do this. We're going to pull out the stops and we're going to do it. And Israel, as we know, has a really long reputation for dealing with crises. They act when they have to do something. They can do it really quickly.

They mobilize and they really set the example for the world in this case. There are drive-through vaccinations. Some clinics run 24-7. Digitized medical records in Israel mean notifications of appointments are online or by text. Canada is not ready for that. I do want to note before we move on, because it's important that Palestinians in the occupied West Bank and in the Gaza Strip will not be vaccinated by Israel. A responsibility that some aid groups believe Israel shares with Palestinian officials. I know that the military is also playing a really important role in vaccinating Israelis.

And Krishana, do you think that the military should be brought in more here in Canada? You know, in Arizona, for example, the National Guard is being brought in as well. In terms of vaccinations, I think, like Andre said, I think Israel did a phenomenal job in terms of mobilizing all the pieces that needed to be mobilized in a timely manner. And if bringing in the military to do so would be helpful, then yes. But I am basically I'm at a point where whatever strategy or whoever is the best strategic lead on this needs to be the person leading this. I think right now we've had so many delays and missteps in preparing for this rollout that I'm quite unsure of who is actually well qualified to do this. Andre, do you have a sense of who you think the best person for the job would be?

Well, you know, we made a big deal of the fact that we appointed these generals in Canada. There's a general running the Canadian aspect. There's a Rick Hillier in Ontario. There's a former general in Alberta. So these are people who are experts in logistics. So this is why we have generals, right? So they're the right people to do it. Now, the question is, do they have the power to do it? So I wrote a couple of weeks ago in a column when Rick Hillier was appointed in Ontario, I said he's going to be in for a nasty surprise. And that's borne out, unfortunately, because when a general tells someone to do something, they give an order, it gets done. That's how it works in the army. In civilian life, when a general gives an order, somebody sets up a committee,

and they talk about it, and they water it down, etc. And I think he's probably extremely frustrated. He knows what needs to be done. He knows we can do it. And we're just not doing it because the politics is getting in the way. So how do how would we fix that? Would we bring in, you know, the rest of the military to report to these generals? Like, what's the answer? I think the simple answer is get out of the way. It's a very common thing that's needed in our healthcare system. Our healthcare system is very micromanaged by politicians, and it should be administered by administrators. So they should say to Rick Hillier, you're in charge, do what you have to do, and we'll sign the checks. If that was the case,

I could assure you that all these vaccines would be in people's arms. If you've ever run logistics at all, it's a nightmare when you have a large operation and you're getting 24, 48 hours notice before we get the shipment. As a way to vaccinate more people, several provinces are now distributing the first dose of the vaccine without reserving the second dose for people. So for example, many who got the first dose of the Pfizer-BioNTech vaccine in Quebec won't be getting the second dose in the coming weeks as initially planned. And what do you think of this plan, Krishana, to delay the second dose? What are the pros? What are the cons? It's been a little bit controversial. So some of the pros, I mean, the main pro to giving the vaccines and delaying the second dose is that the sooner that more Canadians have vaccines in their arms is the better.

Hopefully, the sooner we can reach herd immunity is also the better for the entire country. con to this is, of course, depending on the length of the delay of the second dose, because we do know that the first dose of each of the vaccines needs to be boosted by a second dose, and there's only a specified length of time for delay. Now, delaying that too much longer than that can actually start to make the first dose a little bit irrelevant. So we want to make sure that although we are trying to do this in a timely fashion and get everyone vaccinated, we're also not doing it to a point of not being able to get the second booster shot in arms quick enough as well. Right. I know that something this is something that is happening in the UK, but in the United States, Dr. Anthony Fauci has said that this is not something

that the US is doing, even though he could see the argument for it. He just doesn't think it's worth it and thinks that you get the optimal coverage if you do it the way that you're supposed to 28 days for the Moderna one, 21 later, for the Pfizer one. You know, I can't help but feel here that there is this like incredible lack of imagination that we're seeing in this rollout in the response here. And especially when you look outside of Canada's borders, you know, in Italy, 1500 temporary circular pavilions will be set up in the country city centers. In the UK, they've recruited volunteers, lifeguards, airline staff to help. And, you know, Krishana, I know that we've been talking about sort of bureaucratic systems here, but why? You know, why is it that we're not seeing this kind of imagination here in this country?

Excellent question, Jamie. And I have no idea why. Maybe Andre can tell you why. But currently our healthcare professionals are not, who are qualified and licensed and have the ability to administer vaccines are not even given access to do so within, you know, certain hospitals that they might not currently have privileges at. Then we are definitely not going to see the kind of ingenuity that other countries are doing. Well, I think it goes back to our larger health system. Again, this is just a small part of it, this vaccination campaign. And the reality is our health system doesn't value and it doesn't reward innovation. So it's not surprising at all that we're not

seeing innovation here like we're seeing elsewhere. You know, why don't we do drive-through vaccination? I think this innate small C conservatism, we're going to do the path of least resistance. We're always going to be cautious. And what is the result? The ultimate result is always the same. It's middling results. You know, it's a mediocre response. I hate to hear those answers from you both.

But is there anything that you like? Is there anything that you're seeing in this country that stands out to you? In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem, brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. them do not know their own household income. That's not a typo. 50%. That's because money is confusing. In my new book and podcast, Money for Couples, I help you and your partner create a financial vision together. To listen to this podcast, just search for Money for Couples. Well, I think the provinces are starting to really pick up their socks. I think they got a lot of criticism and justifiably so for, you know, we were one of the first countries in the world to approve this vaccine.

We did our first vaccines December 14th, really early. But then we just kind of lollygaggled for a while. So I think now they've realized the urgency of this. Ontario did 10,000 vaccinations in a day. That's a good start. They have to just keep building on that. So I like that we're finally taking this seriously, but I wish it had happened two and a half weeks ago.

We're ramping up. And again, there's no one in the country that's vaccinating 10,000 people a day. I want to look ahead now and talk to you both about supply. So, Andre, you mentioned Ontario ramping up to 10,000 a day. And on Wednesday, Ontario Premier Doug Ford, despite being criticized for the slow rollout and still having, you know, I should note, something like half the vaccines still sitting in freezers, he said repeatedly that Ontario needs more vaccines. And Andre, you also mentioned earlier that Israel had done an excellent job, you know, ordering early and sort of paying these premiums. And is there a scenario here in which the next stage of this could be a pipeline problem? Could the provinces like essentially catch up and then we do run out of vaccines and then we would be heading towards a supply problem? Could the provinces like essentially catch up and then we do run out of vaccines

and then we would be heading towards a supply problem? I would say it's 100% certain that we're going to have a supply problem in very short order. We know that. Is that solvable? Probably not at this point. It goes back to we waited late to order. We tried to make up for it by signing a lot of contracts. We've signed contracts with seven different manufacturers for about 400 million doses. Now the question though is when will those doses arrive and it's not going to be quickly. I wonder if I could ask you both to reflect on what you think the next six months is actually going to look like. Considering everything that we've discussed and what Andre just mentioned,

especially around the supply issue, I think one of the most important points, though, that we should make to the public is whether or not you have been vaccinated is for people to continue to follow public health measures, for people to continue wearing their masks, continue with physical distancing, continuing to stay at home if they're ever so privileged to do so,

especially if they're sick, and continue to wash hands and not mix within households. I'm definitely sure we're going to continue to see our situation that we're in right now be extended for several more months. I don't see us being able to be out and about normally within the next six months. So I think we all need to hunker down and realize that we're probably going to continue to be in this current situation. All right, Andre, final word to you. Well, I really hate to say this, but I think that all the indications are that the next two, three months are actually going to be the worst of the pandemic yet. So I think there's a lot of dark days ahead. But the light at the end of the tunnel is vaccines,

getting vaccines into people. But that realistically is only going to start on a large scale in the spring and the summer. And what we have to recognize about vaccines is that they are not a short-term strategy. They're a long-term strategy. In the short term, we just have to do the same old boring stuff that we haven't been doing very well. That's the real challenge. And it's going to get harder and harder. We're going to have some harsh measures coming down in the country, lockdowns, curfews, even more severe than we've seen. And it's going to be really frustrating for people because it's going to take time for those to have an impact. So dark days ahead, but if we

hang in there, I think by the spring, things are going to get much, much better. All right. A sort of hopeful note to end on. Thank you very much to you both. We're very appreciative. Thank you. Thank you. Before we go today, some news on the aftermath of the Capitol Hill riot. Democratic House Speaker Nancy Pelosi has called for U.S. President Donald Trump to be removed from office for what she called inciting sedition. The gleeful desecration of the U.S. Capitol, which is the temple of our American democracy, and the violence targeting Congress are horrors that will forever stain our nation's history. Instigated by the President of the United States.

That's why it's such a stain. In calling for this seditious act, the President has committed an unspeakable assault on our nation and our people. Pelosi, along with Senate Democratic Leader Chuck Schumer, are calling on Vice President Mike Pence to use the 25th Amendment to remove Trump. They also said that Democrats in Congress are prepared to act if Pence doesn't and mention the possibility of impeachment. All right, that is all for this week. FrontBurner is brought to you by CBC News and CBC Podcasts. The show is produced this week by Imogen Burchard, Elaine Chao, Shannon Higgins, and Ali Janes. Our sound design was by Derek Vanderwyk and Matt Cameron. Our music is by Joseph Shabison, a boombox sound. The executive producer of Front Burner

is Nick McCabe-Locos. And I'm Jamie Poisson. Thanks so much for listening. And we'll talk to you next week. For more CBC Podcasts, go to cbc.ca slash podcasts.