The Bridge with Peter Mansbridge - Blunt New Talk On Covid in Canada

Episode Date: April 5, 2021

Who's winning between the variants and the vaccines?  Dr Isaac Bogoch doesn't hold back on giving his answer on this and some other key questions about where we are on Covid. All this while Britain starts a serious reopening program.

Hello there, I'm Peter Mansbridge and you are just moments away from the latest episode of The Bridge and today, another episode of Blunt Talk And hello there, yes, Peter Mansbridge here and if there's anything our program has become known for in the last couple of weeks anyway, is this issue of some blunt talk on episodes and issues that affect us directly. Now, a couple of weeks ago, we had blunt talk on China and Canada, especially as it regards the two Michaels. We've had blunt talk on vaccines,

and you know that that is something of major concern to you. But overall, the biggest topic of discussion for Canadians from coast to coast to coast is the pandemic. Where do things stand? Where do they really stand on this issue? Well, today, some blunt talk, and it's coming from a pretty familiar place. One of the epidemiologists that we've been talking to, infectious disease specialists that we've been

talking to over the past year, one of a handful of those from different parts of the country that we've been talking to is Dr. Isaac Bogoch in Toronto. And I got a hold of him last night because I wanted to ask some sort of kind of basic questions of where we are right now. And he was working last night. He agreed. He said, look, I have a break. And when I say working, he was at the hospital. He was next to the COVID ward and was in and out of there through a good chunk of yesterday. And he had a break scheduled, and he said, let's do it then. And I think one of the reasons he was so blunt in this discussion that I'll be playing for you is that, yeah, there he was looking at it

as he does almost daily, but here he was looking at it as he does, you know, almost daily, but here he was right in the middle of it, dealing with COVID patients, dealing with the issue firsthand. And so we had a good discussion. I'm going to play it in its entirety in a couple of minutes. Let me set the scene in many ways in terms of what we're looking at in a good chunk of the world. In other words, Europe, the United Kingdom, North America. There's only one of those places where things actually seem, at least they seem, to be looking up. And that's in the United Kingdom, where they've had a very successful, you know, things did not start well from them.

Remember a year ago right now, the Prime Minister, Boris Johnson, was in intensive care unit in a London hospital. Things looked brutal. They went into a big lockdown. It was not good. And skyrocketing rates of cases and deaths. But right now, things seem to be, let's see how it turns out here. While Europe is battling another wave and there's shutdowns and lockdowns

in France and Germany and Italy that rival what we witnessed last year at this time, UK is looking a lot different. Very successful vaccine program. They have their own AstraZeneca. They also have Pfizer. They vaccinated a huge chunk of the population. They've started opening up across the UK.

Scotland, which has always been hesitant to duplicate what was going on in England, are starting to open up as well. But the UK announcing today they're going to give out free two test kits a week to those who come to pharmacies and other drop-off points to pick them up. That's part of their move going forward. They are going to ask for a form of vaccine passports in certain areas. And the ones they're testing out over the next couple of weeks are all the things, comedy clubs, dance halls.

They want to see that you have been vaccinated before they let you in. Now, how far are they going to go with that? They say they will not go to the point of, you know, shopping malls and stores, et cetera. That won't be happening, grocery stores, any of that. They're testing it out in some areas the test results this is something that everybody has argued for for the last year

in different countries everywhere including this one that we don't do enough testing here they're going to offer rapid testing, results within 30 minutes, free, twice a week. So it'll be very interesting to watch what happens in the United Kingdom, how this works out, whether they have, as a result of reopening now,

a reversal of fortune, which we've witnessed everywhere else, certainly here in parts of Canada. So, that's kind of the lay of the land. When we come back, the interview that I promised with Dr. Isaac Bogoch, and believe me,

it's pretty blunt and direct in terms of what he has to say. That's when we come back. Okay. So once again, infectious disease specialist, Dr. Isaac Bogoch works in Toronto. He was on duty yesterday at one of the hospitals that he

is working at. His major concern for the past year, almost a dozen to 20 hours a day has been COVID and the battle against COVID. And he's also involved in the vaccine distribution plan. So he's got it coming at him from all directions. And he's pretty realistic, as you're about to hear in this interview. Well, Doctor, everybody talks about the race between the variants and the vaccines if we talk

about that race today who's winning the variants are winning by a mile it's really unfortunate we kind of knew this was going to happen uh probably about a month ago but it's really coming to uh realization now and uh you know vaccines are rolling out and of course they are having a very positive impact they're not going to halt the third wave they can mitigate a third wave they can prevent death and suffering during a third wave but the vaccines alone aren't going to halt a third wave we really need more measures in place to halt the third wave like what well glad you asked. Several different things. Well, for starters, you know, when we're in a position, at least in Ontario, for example,

where our health care system is truly getting stretched beyond capacity. I mean, our ICUs are just packed. You know, you're really at a state where you don't have a lot of options that bring cases down quickly. You just you don't have very many options. And sadly, a lockdown is really one of your last options. And, you know, if we recreated what we did in early January, I think that would help. But that in and of itself doesn't entirely solve the problem. That gets cases to go down relatively quickly quickly but that doesn't solve your entire problem it just decompresses your health care system temporarily what the other thing you need

to do is of course look upstream look at the drivers of infection in your community and we know for example in ontario i don't mean to be ontario centric i'm just sitting in downtown toronto right now but we know that a lot of the drivers of infection are really, unfortunately, in workplaces, in essential workers, amplified when people get infected at work and bring it home, for example. So you've got to look upstream and got to create safer workplaces. Policies like paid sick leave would be very helpful. We call them wraparound services where, you know, you have screening in essential workplaces. And of course, people who test positive can be supported if they need to isolate, they can go to an isolation hotel so they don't go and infect their family as well. And of course,

they can afford to take the 10 to 14 days of time off because they have paid sick leave. So that kind of terminology is almost referred to as wraparound services. So that would be extremely helpful because that's going to help deal with the upstream drivers of infection in the community. So lockdown, which stinks, we all know they stink. We know the financial and mental health repercussions. Number two is creating safe worksplaces and wraparound services. And of course, number three is vaccinate, vaccinate, vaccinate in a data-driven and equitable manner. Of course, for an Ontario phase two has several different mechanisms baked in to really target a hybrid in neighborhoods, including essential workers. And we're starting that program. And actually that plan has already been enacted and we'll be scaling up over the weeks and months ahead.

You know, almost no matter where you look in the country, with the exception of Atlanta, Canada, we're seeing this happen. And we're seeing it happen, I guess, possibly at the worst time because the weather's improving. People want to get outside. They're kind of sick of all this. They don't seem to be listening. As opposed to a year ago at this time when everybody was scared stiff about what was happening and they listened. And for the most part, you know, they followed the rules or the suggestions or the guidelines. That just simply isn't happening right now.

I mean, you look at some of the pictures from this, you know, just the last couple of days. It's pretty bad. Like, what do you say what do you what do you do i mean i think this really is reflective of a much bigger issue which is how do we communicate and get the public on board and your policies have to be aligned with reality and they have to be communicated effectively as well but um i think it's also fair to say that there are things that we can do you know it's not just cut cut cut close down close down close down it's also fair to say that there are things that we can do. You know, it's not just cut, cut, cut, close down, close down, close down.

There's also things that you can do safely that we should be encouraging. Like, for example, you mentioned out of doors. That's great. Get as many people in the out of doors as possible. I'd be encouraging it. I'd be facilitating this. I'd move as much outside as we possibly can. Like it's so much safer out of doors. If you're two meters away from someone,

like there's no way you're getting COVID-19. Of course, there's going to be the one in a gazillion case, but by and large, the out of doors is, is much, much safer than indoor environments. And then again,

I think the policies have to be reflective of the reality on the ground and, and, and have to be communicated in a meaningful and in an impactful manner um i don't think that's being done just quite frankly i don't think it's being done very effectively uh either you know we can look at provincially we can look at municipally we can look at federally there's so much room for improvement on the communication front on the vaccine front um i mean, there's no doubt that the numbers have picked up considerably. Are you happy, you confident where things stand

on the vaccine front at the moment? I mean, no, I'm not. I won't be happy until the program's finished. And I think there certainly are areas that we should be improving on. I would expand the role of primary care in the vaccine rollout and really have primary care have more of an involvement than they do. Now, they are involved, but I would expand their involvement. What do you mean by that? Well, currently in Ontario, for example, there's six public health units that have primary care providers vaccinating. And I'd allocate more vaccine to primary care providers. Because when people trust their primary care providers, that's a lower barrier for many people to go see their primary care provider.

You mean their doctor? Yeah, I say primary care because it really encompasses not just family medicine, but also nurse practitioners. But there's a lot of trust. There's a lot of counseling regarding vaccine hesitancy. There's lower barriers to seeing a primary care provider. I think there's just a lot of good reasons. They can equitably help distribute vaccination. They know their patient population. They can adjudicate who's in the right phase and who should be getting a vaccine. There's a million good reasons why primary care should have a bigger role in this phase of the rollout. So what's the reluctance? Why isn't that happening? What's the reluctance? It's happening. It's just happening slowly.

I think it is, it is going to happen. It's just happening slowly. And I, I put the pedal to the metal on that, on that front. Um, I, the other thing that concerns me too too is, you know, there are ways that you can bake in equity into the vaccine rollout program. But we still need to have better outreach to disproportionately impacted communities to help with the uptake of the vaccine. So, for example, there's more vaccine going into these high burden neighborhoods. There are. The age cutoff is lower in many high burden neighborhoods, and that will continue to expand. The essential workers are prioritized, and you're going to start to see vaccination gearing up in more and more essential workers. You know, that's not at the expense of, you know, age and other medical comorbidities. It's in addition to that as well but i think what we're going to start to see

and what we might start seeing is people not coming out to vaccine clinics people that should be coming out that aren't aren't coming out uh because of i'm going to use the word hesitancy but it's not the right word right i think we need to do more to reach out to communities in an age, culture, language appropriate manner and instill greater confidence in the plan and really try to tailor the program such that there's as few barriers as possible to getting a vaccine. I think there still are barriers, right? There's technological barriers. There's mobility barriers for some individuals. There's language barriers. There's still a lot of barriers. And I think those are going to be challenging to overcome. Where are you at the moment on teachers? And I mean, we know the studies that are going on for kids, for students, but for teachers,

where are you on teachers? Are they not an essential service i mean yeah aren't they i mean if you look at so for example if you look at the phase two vaccine rollout program you will see a whole list of essential workers that are prioritized in state student they're prioritized ahead of the general population now vaccines are certainly rolling in and we're certainly vaccinating more people week after week after week. There's of course room for improvement on this front. There really is room for improvement. We should be vaccinating at a faster pace than we are. But when you look at the prioritization, teachers are prioritized. In addition to other essential

workers, they are prioritized ahead of the general population. But if you look at everyone in phase two, even though we do have more vaccines rolling into the country and into the province, we don't have enough vaccines as of yet to say, okay, everyone in phase two can get a vaccine. We just don't have enough vaccines to do that. I mean, that's just a sad reality. I mean, we still have to triage. So what you're seeing now is triaging based on risk of getting the infection and risk of having a severe outcome from this infection. So what does that mean? Well, you know, if you're 80 years and up, you're going to get the vaccine. If you're 70 years and up, you're going to get the vaccine. I mean, if we look at the risk of death, I mean, I know we're hearing some obviously tragic, tragic stories of young people getting infected

and a few young people dying. And these are awful, awful stories. But if you take a step back and look at, you know, even in the last month, who's dying from COVID-19, it's overwhelmingly people 60 years of age and older. It's overwhelmingly 60 years of age and older. Now, every death is a tragedy. We should be avoiding, we have to protect everybody. We really do. But there still is a scarcity of vaccines. And that's an issue. We can't vaccinate everyone in stage two at the same time. We just can't. There's not enough enough so you still have to triage now what you are seeing though is lower age cutoffs for different uh neighborhoods and you are seeing more vaccines pouring into those high burden areas and you are seeing uh some not as much as anyone would like

but some prioritization for essential workers i mean there's there were about 2,000, 1,500 to 2,000 special ed teachers that were recently vaccinated, for example, in Niagara. These are teachers who are at pretty high risk. They have to be in person with their students. And sometimes, again, said with love and respect, but their students might not be able to adhere to the same distancing measures. They might be some scenarios that arise with the special population that these teachers serve that put them at greater risk. So, like, you can expect to see further triage within essential workers and greater vaccination of essential workers. But you can't just we just don't have enough vaccine to say, yes, all essential workers can get vaccinated now.

And obviously I wish we were in a position, but we're not. You know, you can go online and go clickety-click and see how many vaccines we're getting per week and realize how many people truly need them. There's just not enough. We still have to triage. I want you to put your history hat on here for a moment. You got a problem?

No, okay. Dr. Bogoch is at the hospital. He's knocking on my door, trying to transfer patients to my service right now, mid-conversation. That can wait five minutes. Okay, don't wait if you don't you know obviously what you're doing there is more important than this but here's here's my history question because i mean looking back at it again at the uh you know the 1918 pandemic which lasted uh two years almost exactly two years from uh 1918 to 1920 and the months coincide so a two-year run

their main weapon against the vaccine or excuse me against pandemic at that time was basically the same weapons we have now mass social distancing wash your hands all that they didn't have any vaccines they never had any vaccines through the length of the pandemic because vaccines didn't exist then but that pandemic at great cost i know 50 million deaths around the world um did end it ran its course it went through four waves so the question is, what's really different here? You know, are we doing any better a job than our, you know, those who walk this planet before us 100 years ago or more than 100 years ago now, dealing with that pandemic?

Some of your listeners may understand this next phrase, manishtana ha-virus hazeh. That's a Passover saying, how is this virus different from all other viruses how is this pandemic different from all other pandemics it's the passover story yeah i mean listen a hallmark feature of respiratory pandemics is waves right you've seen it time and time again with with different influenza uh pandemics You've seen it with this coronavirus pandemic. That's a hallmark feature. Vaccines will help mitigate the waves. And certainly when enough of us are vaccinated, it will completely prevent a wave from happening. It will. Listen, as bad as this is right now, while we're neck deep in this third wave, I think we should also ask ourselves, you know, not just who's getting infected and what we need to do, but sort of take a step back and look at the 30,000 foot view and ask, like, who's not getting infected?

Do you remember the devastation and long term care during wave one? Of course we do. Do you remember the devastation and long term care during wave two? Of course we do. We failed our most vulnerable a second time. Do you remember the devastation in long-term care during wave three? No, you don't because it isn't there because they're all vaccinated. This has transformed our epidemic. You notice how our hospital system is being stretched beyond capacity, but you know who's there your hospital workers and your health care providers because we're vaccinated right we are not absentee we

are there we are working because we're protected so you know you look next door from ontario into manitoba there's devastation in many of the northern indigenous communities largely absent in ontario not perfect but largely absent because there was a very successful program to vaccinate remote at-risk communities, and it worked. So I'm not trying to pat anyone on the back. I'm just saying these vaccines are extremely effective, and they do transform the demographic that's affected in this wave. And it will continue to transform how this infection manifests in the community. As we roll these vaccines out, they will quell infection, and they will protect vulnerable people. And eventually, it's too soon, but eventually, you will start to see a case slash hospitalization mismatch. You might see cases, but you'll start

to see fewer and fewer hospitalizations. And then, of course, you're going to start to see fewer and fewer cases eventually as we vaccinate more and more people who are vulnerable. And then, of course, just everybody who wants a vaccine. Last quick thought as we enter yet another week on this story. Where's your head? Because I've heard your head in two different places in the last 15 minutes. There are things that you're really not happy about and pessimistic about as a result. And there are things you're optimistic about as you just ran through the list. So where are you generally? Are you feeling, you know, you tell me. Yeah.

Got an hour. You know, so step one, I'm pretty frustrated about this third wave because a lot of this was largely preventable. Step two, I'm pretty optimistic over the medium term and long term future in Canada because vaccines truly are here and they are rolling out. And no matter how bad you mess up, you really can't throw enough vaccines at the problem and the problem will go away. That's basically where I'm at.

It's not perfect. In fact, it's far from perfect, but it will get better. And as ugly as this third wave is, it really will add and it will get better. And as ugly as this third wave is, it really will end and it will get better. I just really, really want to get through this third wave with as minimal damage to human life as possible.

It's interesting because I'm sitting in my office on the 14th floor of the Toronto General Hospital, a few floors up from the COVID ward, and I've been working here all, all weekend. And, you know, this is at a time where we're getting transferred from other hospitals that are overflowing with patients that have COVID and we're taking them in our

hospital and people are getting choppered to different parts of the province. Like none of this needed to happen. Listen, we, um, you know, we really appreciate what you do,

you and your colleagues. And, and, you know, just listening to you of what these last few days have been like, and I guess it's become the commonplace as we're in this third wave. All we can do is send you our thanks and appreciate what you do and the time you take to give us a few thoughts to consider in all this. So, Dr. Boguch, thank you very much. Have a wonderful weekend.

Isaac Bogoch talking to us from, as he said, his floor at the hospital associated with the University of Toronto and the whole Toronto Hospital Network. And I tell you, it puts so much in, you know, in perspective and in context. When you listen to him, you know, at times he's frustrated, at times he's calm, at times he's, you know, like confident in the direction that things are starting to move in.

Yet at the same time, there he is, as he says, you know, two floors above the COVID ward where he's been working all weekend. You heard in the middle of the interview, there was a knock at the door. One of those he works with had come by, you know, to get him to come along because they just had some new patients transferred. And, you know, and off he went. That's his weekend. And yet at the same time, trying to explain the situation to the rest of us. So many of whom are, you know, frustrated and we've kind of hit that pandemic wall.

You know, we want things to change. Like now we're sick of it. We, we want to move on with our lives and we want to put our lives back together again in so many cases where people have had severe hardship and real hurt so the fact that he's you know i i mean we talk about how we've hit the pandemic wall. Can you imagine what it must be like for them? We're facing this, our frontline healthcare workers, every day, every hour, every week,

for more than a year now. And no immediate end in sight. And we're now in, you know, as he predicted here on the bridge a few weeks ago, we were going to go into a third wave and we're in the third wave. And the third wave is winning. You know, there was a piece over the weekend in the New York Times about hitting the pandemic wall and I think we've all felt this at times and we find our own ways to deal with it

and you know maybe that's the thing I want to hear from you this week is how do you deal with hitting the pandemic wall? What is it? Maybe just some small little thing that you do that others may find helpful for them. So why don't you drop me a line at themansbridgepodcast at gmail.com, themansbridgepodcast at gmail.com, and we'll save up your entries and we'll make it into the weekend special on Friday.

Just like how are you dealing with it? You know, this piece in the New York Times was interesting because there were some examples of what it's like. You'll identify, some of you will anyway, I know I do, with some of this. There was a woman from California who told the Times, I feel like I'm in quicksand. I'm just so exhausted all the time. I'm doing so much less than I normally do.

I'm not traveling. I'm not entertaining. I'm just sitting in front of my computer. But I'm accomplishing way less. It's like a whole new math. I have more time and fewer obligations, yet I'm getting so much less done. You know, as the time says,

you're sitting in the same chair in the same room, staring at the same computer for 12 straight months and counting. And it's left many of us feeling like burned out husks, dim-witted approximations of our once productive selves. Now I'm not sure that's totally true. It's certainly not totally true of all of us. Certainly it is for some of us. I know that one of the ways that I've dealt with this is doing the bridge. It's communicating on a daily basis with you and hearing your thoughts and your concerns and reading your mail.

That's been a savior for me. Getting up each day and thinking, you know what, this is what I want to talk about today, or this is who I want to talk to today. And as I've said many times, it started as a hobby. It turns into, well, a job, you know, the great association with the people at Sirius. And it's been fun. It's been kind of a new life for me.

Yet at the same time, I've hit the wall. And in many days, I'll sit there, you know, staring at the wall. That's why I loved this past weekend. It finally got warm here in Stratford, and I was able to sit outside. I spent most of yesterday sitting outside.

It was fantastic. It reminded me of last summer where I spent so much time in my backyard. I spent a lot of time writing last summer. I'll be able to tell you what I was writing about soon. One of the things they say in this piece is, you know, some of the thoughts that go through your mind when you're hitting the wall. At what time is it? What day is it?

What did we do last month? Why are we standing in front of the refrigerator staring at an old clove of garlic? Just recently, it says in this article, just recently I myself spent half an hour struggling to retrieve a word from the faulty memory system that has replaced my pre-pandemic brain. The word was institution. Sometimes when I try to write a simple email, I feel I'm just pushing disjointed words around, like peas on a plate,

hoping they'll eventually coalesce into sentences. Am I excited about my daily work in this month of April 2021? I'd have to say I am not. So the Times wanted some expert advice on this. So they reached out to a professor of psychiatry at McGill University in Montreal, Natasha Raja. She specializes in memory and the brain. She says the longevity of the pandemic,

endless monotony laced with acute anxiety, had contributed to a sense that time was moving differently, as if this past year were a long, hazy, exhausting experience lasting forever and, at the same time, no time at all. The stress and tedium, she said, have dulled our ability to form meaningful new memories. Yep. I think we've all seen those moments, but we've also all seen,

because I've heard it in many of your letters that you've written over the last year. I've also seen how you've come out of that, hitting at the wall, what you've done to deal with it. So I want to hear that again, and I want to hear what new ways you've come up with. And I'd like to hear from some new people. We have some regulars here, and they've been fantastic. But I know many of you, and there are now,

because I see the numbers, there are thousands and thousands and thousands of people who listen every day to the bridge. And let me know what you're thinking and how you're dealing with this, you know, hitting of the wall. Because if you found ways, it's going to help others. And hopefully we can contribute to that in some fashion. All right. Looking ahead to the week, it's kind of loose at the moment.

Haven't really thought it through. Had a great um you know holiday weekend so i you know i kind of set aside work for most of it but tomorrow uh we'll find something uh to talk about because we always do tuesdays love tuesdays uh wednesday is smoke mirrors and the truth br. Bruce Anderson joins us. Thursday, Potpourri Day. We've got a ton of stuff already saved up of things that we can talk about on Thursday. And Friday is the weekend special.

And hopefully you're going to contribute to that through the letters I talk about. Thursday's also the day for good talk. Been a very successful launch over the first six weeks with Chantal Hébert and Bruce when we talk about national issues. This Thursday where we're taking this week off because Parliament's not sitting right now. They're on their break. And so we'll take this Thursday off from Good Talk. It'll be back next week on Thursday at 5 o'clock on Sirius XM Channel 167. And that's kind of it

for the start of another week. So you take care out there. And I hope you enjoy, once again, it's kind of a tough word, but there was some very blunt talk there from Dr. Bogunch about the situation, keeping in mind where he was when he was talking about it. You know, the day will come when we'll find some special way to thank these people who have been at the front lines for us, helping us, saving us, feeding us, doing the whole bit.

All right. I'm Peter Mansbridge. This has been The Bridge for the beginning of another week. Thanks for listening. We'll talk to you again in 24 hours.