Front Burner - Summer 2021: Expectations vs. reality

Episode Date: May 10, 2021

Canada's vaccine rollout is speeding up, raising the possibility of COVID-19 restrictions loosening in the next few months. Today on Front Burner, infectious disease epidemiologist Dr. Lynora Saxinger talks about the kind of summer we could expect to have.

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. Hi, I'm Jamie Poisson, and in the not-so-distant future... And this just in, we are back. We can see people again. How about that? I can't believe it. News is on the way. We'll learn more in just a moment. I can't believe it. There were nights when the wind was so cold. So I don't know if you've seen this extra gum commercial that went viral last week,

but in it, all these people are waking up to that announcement that you just heard, that it's like, okay now to actually see people. Some have really shaggy beards. Others clearly have not showered in a very long time, but it doesn't matter. They're just dashing out of their dusty apartments. They're storming their offices, they're making out in a park. And that's obviously a commercial for gum, so it's not exactly grounded in reality here. But that whole idea of having the freedom to get out there and to not have to worry about COVID sometime in the near future, are we really getting close to that? Could we actually have a real summer?

I'm Jamie Poisson, and today with the vaccine rollout speeding up in Canada, Dr. Lenora Saxinger is here to talk us through all of this. She's an infectious disease specialist with the University of Alberta based in Edmonton. Hi, Dr. Saksinger. Thank you so much for coming on today. My pleasure. I'm happy to join you. So we've jokingly been calling this episode the summer one, asking for a friend, but that friend is me, definitely, because I really just desperately want some answers here

about what the next few months are gonna look like. So we know that on Friday, Canada set a single day record of 400,000 vaccines delivered, shots per 100 people is around 42, give or take, depending on which province you're in. Ontario, for example, though, is on track to administer first doses to 65% of adults by the end of this month. And how do you feel about the progress being made here? Oh, it is. Oh, it's delightful. I mean, it's all been complicated. Every time we think we have a handle on things, we've gotten kind of a curveball or availability more broadly, and knowing that that really is to some extent our ticket out. Although I'm not sure we're going to have like an unnecessarily like end date or big announcement,

I think it's more going to be kind of a fade. But I really think that it's just we must maintain and protect and, and augment as much as possible. I think that's actually exactly the picture I want to try and get from you today, what that fade will look like. First, I did want to mention, though, right now, as everyone knows, we're operating on a four-month delay for a second dose. But there are some signs that that might be truncated too, right, which is another positive piece of news on the vaccine rollout, right? One thing that people have to keep in mind is that, you know, you make a plan based on the best available information at the moment. And it really is supportable to delay

the second dose for the majority of people to extend that first dose protection to more people, which will actually protect everybody better. Now, if the supply of vaccine exceeds expectations enough that we can circle back earlier and give that second dose earlier, starting with more vulnerable persons, I think that's fantastic. But no one should think that the current plan is set in stone. I think that we're going to see adjustment as we learn and adjustment as we kind of get a better handle on our supplies as well. Right. And as you mentioned, totally in flux right now. But I know that the Globe and Mail is reporting that by the first week of June, enough vaccine doses are expected to arrive in Canada to cover first shots for all eligible Canadians. And then by the end of June, enough vaccine to also cover a second shot for about 17 million

people. But for the people that just have one shot right now and are waiting for a second shot, what do we know about how much protection a first dose gives a person? And I guess just continuing on that asking for a friend theme, I got my vaccine on Friday. So you know, what kind of protection would someone like me have? Congratulations. Oh, thank you. would someone like me have? Congratulations. Oh, thank you. So there's every time someone tells me they've been vaccinated, my heart lifts a tiny bit. It's actually been a very consistent thing, and I'm quite enjoying it. So I think that there's two things to keep in mind about the vaccine first dose protection. One is like people can find it very emotional to get their first dose of vaccine

because it really is like a very palpable reminder that, okay, this is the end game now. Now I'm building protection. And I've kind of gotten the sense that sometimes people sort of start behaving protected before they're necessarily protected. So first cautionary note, first downer note from the ID doc is that, you know, just keep doing things the way you've been doing in a defensive and protective way for at least a couple of weeks, because the protection against, you know, hospitalization and death for all of the vaccines is really, really excellent. But it really doesn't start building until after two weeks after the first shot. And then from that two week after your first dose period forward, you know, there's pretty

wide ranging data. And the numbers kind of settle out somewhere between like 70 and 95% protection against symptomatic illness, which is a big range. But it's not just symptomatic COVID. If you're protected and you get COVID and you get a cold instead of a severe illness, then I think that's still a good outcome. So keep in mind the outcomes and keep in mind that current numbers are going to be subject to change as we learn more. So fixating on one particular number from one study probably isn't going to serve us well. I think it's better to just kind of say, is it a good vaccine or not a good vaccine? How good do we expect it to be? And you are substantially protected from hospitalization and severe outcomes. And then protected from any kind of infection kind of builds over time. Right, right. Even with one dose.

Yeah, exactly. And so for AstraZeneca recipients, there's really good data that the AstraZeneca first dose protection is kind of slower off the mark than the mRNA vaccine. So it starts off protecting well against hospitalization and death, but then the protection from any infection continues to build out to at least three months. And so we have really good evidence that that first dose protection doesn't drop at Okay, so given all of that, you know, as people get their first doses, and as their friends and their other family members get their first doses after that sort of couple of week period where it really needs to kick in to build those antibodies, you know, after that period, what advice would you give people who maybe want to have like a small dinner

party with six or seven people who have all had their first doses or who want to get together and hang out? You know, this is an interesting space because I've noticed that most public health authorities have not really come forward with like a firm direction in that regard. And part of it has been because the data on protection after first dose is just kind of coming in now. And no one really wanted to overstep the bounds of what we know. But on the other hand, there's this pressure that people are like, well, why get immunized if I can't do anything differently? And I think that I'm somewhat sympathetic to that as well. I think that there's a practical place in the middle,

which is, you know, before we've had clear guidance from public health, things that we know reduce risk, like starting from the point that there's no no risk situation right now, like there really isn't. And if you're looking at risk reduction, if everyone has had their first dose of vaccine, they're significantly protected against severe illness. You know, if you gather and you still pay attention to some of those, you know, core basics that we know are helpful, like ventilation, like frequent hand washing, like avoiding kind of, if it's a shared meal situation, avoiding shared utensils, you know, outside is better than inside. All of those things would increase your safety in a, you know, partially vaccinated scenario. None of it really makes you truly bulletproof. So the other thing to think about is who's at the table. Is there

anyone there who would be at risk of not having a strong first dose protection because of a medical condition? And so it's the same kind of like fine tuned thinking about it, that's kind of exhausting, honestly, but is kind of necessary. I really do see a good light at the end of the tunnel. I just don't want to jump the gun on saying, kind of fly and be free without being able to kind of quantify what the risks might be so people can make a decision that's informed, right? And so speaking of that guidance, you know, I think we're already starting to see a little bit of it. In late April, federal officials suggested that once Canada hits at least three quarters

of the population getting one vaccine dose, it may be possible to start winding down lockdowns over the summer. be possible to start winding down lockdowns over the summer. Theresa Tam, Canada's chief public health officer, noted once she sees 20% of the country that has been fully vaccinated, she thinks officials can also start easing the most stringent restrictions. These models give us hope, illustrating that there is a safe way to lift most restrictive public health measures, like certain work plays and business closures, by this summer, if enough people get vaccinated. And can you take me through what you think that is actually going to look like?

You know, you mentioned before this fade. I guess one thing is there's the visible stuff. So the visible stuff are like public masking, are like restrictions on businesses and public gathering places. And a lot of that, I think we have to maintain both because we're wanting some certainty about what the risks are if we drop them. And lots of places have shown us that if you open those things up too quickly before you have good vaccine coverage, that you can get another flare. And so I don't think anyone has the stomach for another flare. So, you know, just kind of being cautious on those things. The other thing is, if not everyone has had an opportunity yet, like a real

opportunity to get their vaccine, you know, saying, well, you don't have to bother masking anymore, means that you'll have this mixed situation in public places where some people aren't wearing masks, others are, and looking at them, you don't know whether they're a jerk or whether they've been vaccinated. And that could really create some issues with social cohesion. And I think that that kind of like group cohesion is really an important part of a COVID response. And so I would see public masking as being one of the last things to go. I think activities that people, you know, do in gatherings and private spaces are something where, you know, once we can kind of put a little bit of a objective spin on what the risks are, I think that that would be something that probably would lighten up more quickly in terms of saying it is okay to do this, you know. Well, and to be honest, I think that's some of the things that people miss the most. And so we have to kind of acknowledge that and honor that people have given up a lot for a long time. And so I would like to see some guidance around, you know, gathering amongst vaccinated persons and how to minimize any potential risk, which I think will

be low. And, you know, and at the same time, you're actually not flaunting it in front of people who haven't had a chance for a shot yet so I think that that's a nice compromise position to look at. I want to take you through some scenarios if you don't mind. And maybe you could tell me how likely you think they are. So Prime Minister Trudeau said last week that he's in talks with other countries about the prospect of vaccine passports. We talked about this on our show on Friday. And he said that if everything goes well with efforts to eradicate the virus, that Canadians could perhaps travel again this summer. that Canadians could perhaps travel again this summer. As people start to travel again, perhaps this summer,

if everything goes well, it would make sense for us to align with partners around the world on some sort of proof of vaccination or vaccine certification. What do you think? Do you think that we'll be able to get on a plane and travel this summer maybe to New York or maybe to the UK? You know, I think we're going to see kind of a global patchwork of COVID control. And the one thing that everyone has to keep in mind is that although the vaccines are remarkably good, nothing is perfect. I think a lot of the US will actually be in a good position because

the places that had really horribly high rates of natural infection, plus now even moderate vaccine rollout are doing okay. Of course, that came at a high cost. There's going to be a lot of countries that are really still struggling with vaccine access and with ongoing infection. And because it's not impossible to get infected after vaccine, like I don't think we should oversell that. I think that you would just have to look at where you're going and assess accordingly

and your reasons for going to, you know, if you had to go to a country that had a lot of uncontrolled COVID, but it was for compelling family reasons. Yes, being vaccinated protects you. Yes, you'd want to make sure if there's boosters needed that you do that and you'd maintain your protective behaviors, but it well could be worth doing. So I think we're going to see a lot more inter-Canadian travel and, you know, some cross-border travel increasing over the summer as well. And what do you think about the current border controls that the government has? So this mandatory quarantine that you have to do in a hotel if you fly in to Canada, do you think that that will be lifted relatively soon for

people who maybe are fully vaccinated? I think for the fully vaccinated, it would probably be reasonable to lift that fairly early on based on what we know right now. The one other thing that makes this all kind of, it's just such an evolving situation, was if we were aware of a new variant that had a higher rate of breakthrough infections against currently available vaccines, that we might have to replace those restrictions because then we don't want to reintroduce a new strain into the communities. So far, the vaccines that we have and the variants that we have, it's been a very reassuring picture that we're going to stay okay. And there are going to be boosters developed against the most common circulating mutations

that the variants have in common. So it might be a situation where we're going to have to update at some point. But at the moment, it all looks pretty promising. And I do think that that will be able to be dropped once we see enough people vaccinated. What about children? So now children 12 and up can get the Pfizer-BioNTech vaccine.

Health Canada reviewed data from a trial done months ago. It included nearly 2,300 American children aged 12 to 15. Among the kids who received the placebo, there were 18 COVID infections. In the vaccinated group, there were none. And, you know, I know that a lot of these questions are dependent on the context that you're putting around all of them. But do you think the kids are going to be back in the classroom in September across the country? And, you know, I know that a lot of these questions are dependent on the context that you're putting around all of them. But do you think the kids are going to be back in the classroom in September across the country? And if so, what does school actually look like?

I'm feeling very positive about next year being a much more stable year for kids. I mean, kids and youth have had to give up so much over the last while. It's really quite heartbreaking, honestly. They actually have been consistently at quite low risk of getting significant illness from COVID. Experience from Israel, especially, because they had this really intense mass vaccination rollout that didn't take that long, it was quite impressive, showed that as soon as you started vaccinating the adults, the overall disease in the community dropped an awful lot, including in kids. And so even if we don't have, you know, full vaccine coverage of all children and youth by the fall, I really think that as long as, you know, the vaccine rollout kind of stays the way it's been running, that it

will be much safer for them, even if we don't have absolutely every single child vaccinated. We will be getting a lot more data on vaccines. Moderna trial is ongoing. There's quite a number of trials right now for kids. Many of them are from like, you know, youth age kids, 12 and up. But there's also one starting at age 5, 6, and even one starting at 6 months forward. And I think the bar for safety for these vaccines in kids, because the disease is less severe, has to be really, really, really high. And I wouldn't want to rush results. I want to make sure that we can say with a lot of clarity how safe they are. But we know that the kids will be protected by controlling the disease in the

community. So I'm feeling very optimistic about school and I'm, you know, I'm kind of excited that it'll feel so much better next year. 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. Hi, it's Ramit Sethi here. You may have seen my money show on Netflix. I've been talking about money for 20 years. I've talked to millions of people and I have some startling numbers to share with you. Did you know that of the people I speak to, 50% of 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 Cups. You do hear a lot of talk about a fourth wave. I absolutely understand what that looks like if we opened up like tomorrow with still, you know, not 50% of the country vaccinated. Like, of course, you could see how the virus could rip around the community. But you also hear people talk about the possibility of a fourth wave once there is pretty, pretty good vaccine coverage. And when they talk about that, what are they talking about? Is it pockets? Is it variants? I would say that once we've reached a certain amount of, you know, population

level immunization coverage, that a fourth wave in the kind of sense that we think of these waves is actually very unlikely. We might see a series of ripples, and that the ripples would be more likely related to areas with lesser vaccine coverage. And so, you know, you might not have the disease disappear from an entire province, but you would have these little hot spots crop up and they wouldn't kind of take hold and they wouldn't spread the way they have been. And so it would be this kind of background flurries, I guess, of COVID in the background. And of course, because nothing is perfect, you would see some vaccine, you know, post-vaccination infections and people exposed to that, which is very much what we see for the other vaccine preventable diseases. The other thing is, of course, the whole variant story is the thing that's the largest potential curveball

in terms of an actual fourth wave. I think that it's likely we'll be able to stay ahead of the variants in terms of sequencing, seeing what's happening. And because the vaccine platforms that we're using are actually really like they're brilliant, they're so good. You can actually change the vaccine to adapt to different mutations in the virus spike protein quite quickly. And so I actually think that it's unlikely we would see a big, large kind of pandemic fourth wave related to a variant which I have been asking a lot of people. When we do, you know, hopefully, knock on wood, open up more this summer, what are you dying to do once things get back to normal a bit more?

Wow, you know, it's, I just really want to be able to go and socialize with family and friends without having that edge of worry and you know travel within Canada to see family and friends is like the top of my list and just do the things that we've done in summers past and have it feel good and I think that will be brilliant okay well sounds great I really hope that you get to do that that we all get to do that but this conversation is giving me confidence that that is coming. So Dr. Soxinger, thank you so much. My pleasure, really. Thank you. All right, so speaking of the possibility of post-quarantine life, there was this pretty funny sketch from Saturday Night Live on the weekend.

It was about just how awkward everything will be once we do get to hang out again. Have a listen. What's summer even going to be like? I know, right? Like, will people travel and do stuff? I will get on a plane with you right now. Is she my cousin? I feel like I'm floating with someone that might be my cousin. So did you travel at all?

No. You? No. Is this really a conversation? I think this is going pretty well. So that is Elon Musk you heard at the end there. The Tesla CEO and second richest man in the world hosted SNL on Saturday. And many people predicted he would talk about Dogecoin during his appearance.

That's this cryptocurrency that started out as a joke that he's been talking up a lot online. And on Sunday, after Musk called it the future of currency and his hustle on SNL, Dogecoin actually lost more than a third of its price. All right, that's all for today. I'm Jamie Poisson. Thanks so much for listening to FrontBurner. We'll talk to you tomorrow.