The Bridge with Peter Mansbridge - Forcing The Issue On Second Doses

Episode Date: June 14, 2021

Is fear of the Delta variant being used to force the rush for second doses? And is there a problem with that?  Dr Lisa Barrett joins us from Halifax for that discussion. Plus, all that plexiglass separating us -- did it do anything?

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Enter referral code PODCAST20 to get $20 free when you make your first deposit. And hello there, Peter Mansbridge here once again. This is The Bridge. We welcome another week. I don't know what number of weeks this is now that we've been covering primarily the COVID story. And Mondays, we always cover the COVID story. And Mondays, we always cover the COVID story. As somebody mentioned last week in the kind of mailbag, the weekend special, they love Mondays because they figure they get a real sense of what's going on in terms of the COVID story, especially not from somebody who's spinning,

not from a politician, not from a premier, prime minister, minister, but from the infectious disease specialists themselves. And as you know, we have four of the great ones in the country, one Halifax and Toronto, Hamilton, Edmonton. And each Monday we talk to them, usually at some degree of length, you know, 15, 18 minutes. And what a number of people have mentioned over time is they really enjoy the conversations because they don't feel they're constrained by time, as many news organizations obviously are, where they're trying to squeeze a lot of information into a minute or two minutes.

We take a different approach here on the bridge on Mondays. We talk and we let our guests talk. And perhaps not enough for some people, perhaps too much for others. But we try to find a happy medium. And all of these infectious disease specialists who've become the rock stars of coverage of this story over the last year because they give it to you straight up. They don't all agree, by the way, and that's important to note.

You know, they do have differences of opinion on some things, and that's been the beauty of the diversity of the group that we've had because on different issues, they don't necessarily have the same opinion. Today's turn is Dr. Lisa Barrett from Halifax. Dr. Barrett is at Dalhousie University in Halifax but she also is a doctor and she deals with patients, COVID patients. And she has offices in the hospital, at the lab, at her home, at the university. So she's a busy person. And I usually do these interviews on Sunday night, trying to look for a little downtime on the part of the guests and not interfere with them during the day.

So I tracked Dr. Barrett down last night for our discussion, and at first she had to delay it by a couple of hours because she had to go into the hospital. There was a new COVID patient there, and she was one of those who was part of the team dealing with the concerns of that particular patient. So we did find a track down last night, and it was getting late into the evening, Halifax time, for the discussion.

But I decided there were obviously a number of things that I wanted to talk to Dr. Barrett about, and you'll hear those. But I decided I wanted to start on a, you know, not a, how do I word this? Not necessarily a personal view, but I want to get a sense of what her life has been like for this, you know, last year and a half, really, but especially so in the last four or five months where they've been, you know, it has been tricky in Nova Scotia, and she's been a part of that team dealing with that situation. So therefore, I started in a particular way. So why don't we, why don't we roll that tape? How often do you go to the hospital? To my office? Not often anymore. To my space where myself and

another person are working with COVID patients? Every day. That would be a fair assumption since April. Yeah. And yeah, it keeps me out of trouble mostly. Since April of this year or April of last year? April of this year. April of this year. A lot of the work that I was doing in the previous waves, when we had very few hospitalized patients, took me to different places, whether that was in the community doing testing work or meetings around planning type things, or my lab, because we do immunology of viruses, including COVID. So I have a basic science lab as well.

So that kept me busy a lot. But when there are inpatients, which have been mostly confined to wave one and three for us in Nova Scotia, then it's an everyday thing along with colleagues of mine. But yeah, every day. Yeah. You know, I appreciate that this is what you wanted to do with your life you know this is what you train for this is why you do what you do but do you find yourself

since april having to steal yourself each day going in it's uh it's a little bit intense at this point and i'm i'm gonna be honest not because of the patient care part um looking after patients i find a joy and a privilege but i also find it encompassing some of my colleagues who do it a hundred percent of the time um who don't do other types of work like research and other things they get used to it and they have a certain rhythm. I find it all encompassing when I'm doing it. There's no balance with me when I'm doing patient care. I'm there for the patient care, cannot look up. that I find increasingly I have to steal for when I go in is that you see the face of COVID

and then you see the questions that are coming up societally, politically, governmentally, about where we go and how we handle what we expect at the next stage of the pandemic, whether people want low suppression of the virus or the next stage of the pandemic, whether people want low suppression of the virus or lots of suppression of the virus, or they want to accept a certain amount because they're just really tired of everything. And honestly, that's my biggest stealing point or my rub point at the moment is that I see a lot of questions coming up, which are valid ones societally for Canadians about what we want to do next with this virus and this pandemic. And not everyone, I think, is in agreement. Some people think it's okay to accept a certain amount of risk.

Some people think it's okay to accept a lot of risk. And some people think it's okay to go for a different plan than we have for flu. And so, honestly, that's one of the biggest rubs. When I see people in hospital and I see the human face, when I watch some of the other plans starting to roll out, I wonder if we should be asking more societal questions about what Canadians really want for the next stage of their pandemic. That's pretty heavy stuff. Yes. It's a big conversation. You're right. And it's going on in different, you know, in different provinces and different governments, you know, across the country. So I wanted to talk a little bit about vaccines

because we're in this kind of unique situation in Canada. On the one hand, we have in terms of first doses, I think we got the best number now in the world. We do. It's approaching 70%. On the other hand, in terms of two doses, full vaccination, we're starting to move, but we're down around like 12%. A long way to go. And I'm wondering, because there seems to be some concern on the part of some people about that gap,

that it's a significant gap and it doesn't really seem to be closing. The first dose numbers are going up quickly, and the second dose numbers are starting to go up quickly. But there's a huge gap. How concerned are you about that? I'm concerned if we don't recognize that one dose of vaccine to me doesn't let me use the word vaccinated and protected. It lets me use the word first dose. It doesn't make me use the words vaccinated and protected. It lets me use the word first dose. It doesn't make me use the words vaccinated and protected. And I think that message may be lost a little bit in the mix for people.

And that's when I get worried. The reason we haven't got a lot of second doses in is we prioritize first dose check. That was probably a a good strategy and we didn't have the supply until the last number of weeks to start doing that kind of rollout for second doses so am i worried that the logistics are not there or that we're not going to be able to get the doses to offer people no i think right now we're in a good point for that. My bigger concerns are that people, number one, are going to start to act like fully vaccinated and protected people a little before they should. And that's not good news with Delta variant and Delta variants, friends that are going to start showing up soon. Let's all be clear. And number two, I think that I'm a little concerned that as we get further in and people think they've got one dose, the rate of second dose starts to tail off and or the

number of people getting the first dose is tailing off because they think other people are going to protect them. So those are my concerns, not logistics, not operations at this point. It's do people understand the limitations of one dose? And number two, do they understand the limitations of not either getting their first or second dose for the rest of the people around them? And I think that's something we need to concentrate on a little bit for the next number of weeks. You mentioned the Delta variant, and I think most people are now aware of it, but they also, it seems to me that that is being used as a reason why you better get a second dose. It's almost like it's a convenient reason to force that issue for those who may be hesitant. It's saying, listen, one dose is not going to do you

to deal with this particular variant. So you better get your second dose now. And there seems to actually, I don't know what it's like there, but it seems to be in central Canada anyway, there is kind of a rush to get the second dose, and it seems to be in in central canada anyway there is kind of a rush to get the second dose and it seems to be because of that yeah and and i think that's fair i don't think that's fear-mongering at all truly more transmittable um and more worrisomely, I can't even say that word, worrisomely, you know, again, immunity is not an on-off switch. It's a dimmer switch.

Even with the second dose, the dimmer goes down a bit. Still exceptionally effective against the Delta variant. But if you let the Delta variant grow in a group of people that only get one shot it's like delta variant disneyland because it's the perfect environment for this um delta variants already done a little bit of a good job of starting to evade the immune system if you give people one dose it gets even smarter against the immune system without getting fully suppressed. And that's bad news. That's exactly what the virus wants, because then it'll make a new version of itself.

That's more immune. And then it'll continue on and cause more havoc. So you really do need to get that second dose. And it is not just because this virus as Delta itself is dangerous, but if you leave a great big group of people that are only partially vaccinated and let this Delta virus move through, its job is to get more evading of the immune system. And that's what will happen with only one dose in arms. You will allow that opportunity, that Disneyland for viruses to propagate before people get the second dose. So second doses and fast are important.

I want to back you up a little bit for something you said earlier, because it intrigued me when you said the first dose strategy that Canada had, you thought was a good thing. Now, you kind of hesitated in the way you said it, but you did say something about good. Yeah. And I raise it simply because we were kind of alone on that track out there. You know, other countries weren't doing it that way. But we decided to go that way. So was it a good thing?

Or was it something that we may regret later on? No, I don't think we should regret it. I mean, and here i speak more as an immunologist and a bit as an infectious disease person and then thirdly my third hat that's sitting on the side there is knowing what's possible so you have to take the art of the possible when you're looking at a situation right um the immunologist in me would have wanted two doses in everyone if we could. So if you had a big spaced out province with lots of space and very few cases,

like Nova Scotia did in the beginning, you'd start reserving your second dose because you know that second doses are where you're going to get your true protection and you're going to want to do that. But we didn't have the ability to get enough vaccine out for even partial protection to all of canadians at the beginning at that time and that's why this the prioritized first dose made sense but it is taking into account that we kind of said well we just can't do these lockdowns and keeping people apart things anymore which well we might have been able to for a few more months and done second dose first but it would have delayed things i i truly do believe that in the situation we were in with the supply we had that prioritizing first doses

was best i don't think it's going to completely um make us at risk as a country overall. I think that was a good strategy with our current supply. Do I think getting second doses out to people fast is really important? Yes. Do I think it's only important to get them to hotspots? No, I think in those hotspots, you're going to have to just make sure you use the other tools in that toolbox really well as also. So not just vaccines, testing, and a little bit of distancing, masking until you can

get it under control for two or three weeks. This is not forever, folks. We've got horizons now. So that's a really long-winded way of saying, I think generally as an immunologist at the beginning, I would have chosen to have enough vaccine to give everyone the right two doses at the right time that would have been best couldn't do it so then you switch to second dose being deferred doing first dose only great but right now second dose is fast it's really important it'll help us um but in the meantime again if you if you leave the star player out there that vaccine on its own without without all the other tools in the toolbox and you reduce restrictions too fast even in those hot spots that will be a problem

because delta variant is immune smart and it will generate immune smart progeny and offspring that are going to be a real freaking problem. And I say that as honestly as I can. We have to be careful at this point. This this virus is getting smarter. Can't give it the chance to do that. Second dose is fast as one way, but we can't go too fast on all the other stuff and as you know um some places are within our country starting to go fast and i wonder what the lesson is that we should be taking by looking at our friends in the united kingdom who um you

know they're they are actually one of the countries that's leading the world in fully vaccination, fully vaccinated citizens. And yet they're putting the brakes on, on their big reopening plan. Yeah, imagine that. So, I mean, I don't know. I kind of sound a bit like a broken record here. You watch the numbers. They also had a great home testing program. I don't have all the information from their country,

but from what I'm piecing together, places that have lower vaccine rates and not as much uptake on the home testing together or people who don't get their second dose or first dose of vaccines are little places where the virus this delta virus sets in can take hold and then if you're not testing enough in that same area, there's an outswing of virus that leads to more hospitalizations and death. I'm not smart. This is just what we've seen

and this is what viruses do for a living. And I'm sorry we're all tired and I'm sorry we all want to travel. I would love to be going to my favorite restaurants in Toronto right now but if we aren't careful about the continued testing and the continued incentivization for people to do public health things like get vaccinated we're going to have trouble and p.s if if we don't have that, the reason the UK is going to come out of this a little bit okay, I think, is that they had a lot of testing

ongoing. Even though they had, they watched numbers go down, it was a huge success, they had all that testing in place. And then they got that early detection warning system. And that's not only useful for them right now for this wave. This is also useful as that the G7 is talking about pandemic planning and also prevention of further outbreaks. That's the tool. It's vaccination, but it's also testing. And if we don't keep it up, we can, we can, we can tell the G7 now that this is going to keep happening unless people keep testing going. And it's tough because it's not the way that public health wants to head with surveillance. So we have to think differently. I'm going to leave it at that. Although, you know, I gotta, I gotta say,

I know you choose your words very carefully. You always have. And, you know, I'm glad you do. But I think, you know, I'm like a lot of people, perhaps you as well, that we're looking towards this summer as, man, finally, we're kind of there. You know, we're almost there. And it's going to be a good summer. And now all of a sudden, as we get to the beginning of the summer, there's this feeling like, geez, you know, we're definitely not there yet,

and it could turn ugly again. Am I overstating that? It could, but I'm going to go on a limb here and say, gosh darn well shouldn't, because we are a very privileged country. Information sharing, tools like vaccines, tools like testing. inconvenience of testing at big festivals or making sure that people have incentives for getting vaccinated, if we choose not to do those minor inconveniences, it could turn ugly. If we choose a slightly different path, and again, I'm not saying that vaccines are not the panacea. They are pretty close to it, but let's support them. Yes, it could be nasty. And if we don't keep an eye on

our borders and keep that massive amount of testing up, it could be ugly. I don't think quite as ugly right away. I think it'll go into the fall um but we can still have an amazing summer an amazing summer with getting a shot twice most people have had the first one so getting your second shot and doing some testing at if you're not going to do asymptomatic testing across the country then just do it at events and workplaces we can keep a huge lid on this if we do simple stuff. And I can tell you, I can still go outside, take pictures of lady slippers until the cows come home and have a really great summer with a moderate-sized bubble.

So I think we just have to set our expectations a little bit realistically. We kind of got to add all that up a little bit realistically. We kind of got to add all top a little bit and say a great summer. This summer might be getting your second shot, doing testing where we can to kind of keep a lid on this, keeping our borders reasonable and still doing a whole bunch of things with a moderate number of people. That's not a terrible summer. Dr. Lisa Barrettrett thank you once again thank you dr lisa barrett uh from dalhousie university talking to us from halifax

where she'd just been at the hospital as we explained at the beginning of all that. But, you know, lots more food for thought there. As, you know, we have been lucky enough to have in our conversations with infectious disease specialists from across the country on our Monday morning segments. And, you know, I really appreciate their time. I know I say this every week, but, you know, they don't have to do this. They got enough stuff on their plate. But I've never had one of them say no. You know, I've had to just a little bit because of their schedules, but it's always been yes, always helpful, always there,

throw anything at them in terms of questions, and they give you their straight- up answers, you know, as best they can. So that's that portion of the program for today. But there is more. There is more. And it's coming at you right after this. Okay, Peter Mansbridge here.

It's The Bridge for a Monday. You're listening on, well, any number of different ways. You could be listening on the podcast platform of your choice, where the bridge goes up every day at noon Eastern. It's also available for you on Sirius XM Canada, channel 167, Canada Talks. And therefore you can listen, well, you know, in your car. And a lot of people do listen in their car. It's broadcast at noon Eastern, and then rebroadcast later in the day at 5 o'clock Eastern.

And we're glad to have Sirius as a partner on the bridge. Okay. Here's something you how many times in the last year and a half have you been somewhere or you've seen on television something like this plexiglass separating people. Right? It's been a big deal. I can remember the first time that I, you know, I mean, there have been plexiglass barriers at grocery stores

and at some other places that have been open, allowing sight and discussion between customers and staff, but they've been separated by plexiglass. And that, of course, has been a safety feature as a result of COVID. But I've seen it used in extremes. You know, you watch, or you used to watch, not so much anymore, but you'd watch sporting events that were open and being allowed to run, and yet when they'd cut to the booth, so to speak,

where the commentators were, they'd be sitting, you know sitting fairly close to each other, but separated by plexiglass. And in some attempts at a very limited form of theater have taken place where there was no audience, but they were filming it. And I think they did one of these in Stratford not too long ago. In fact, I know they did because my wife was involved in one of them.

And they had the different people on stage separated by plexiglass. Safety feature, right? That's why it was there. So that's been going on since early last year. And we're just getting around to, because in many cases, especially in the States, that plexiglass is coming down. You watch sporting events now, and the commentators are actually sitting beside each other.

You watch Hockey Night in Canada. They're all sitting at a table with Ron, right? There's no, well, they're not all sitting at a table with Ron, right? There's no, well, they're not all sitting at a table with Ron, but some of them are, and some of them are broadcasting remote from their homes. You know, in different parts of the country. Anyway, the ones in studio are not separated anymore by plexiglass. And after a year where plexiglass has been everywhere, retail stores and restaurants and schools and offices,

because they all race to erect these clear plastic shields when the pandemic hit. So Bloomberg has been doing some reporting on this. And they say that U.S. sales of plexiglass in the last year tripled to roughly $750 million in that rush for protection from the droplets that health authorities suspected were spreading the coronavirus. Now, here's the interesting part. In the States anyway, Bloomberg reports,

there's just one hitch in this. To this day, not a single study has shown that the clear plastic barriers actually control the virus. That's according to Harvard University's indoor air researcher, Joseph Allen, who calls the Plexiglass shields hygiene theater. For the first months of COVID-19, top health authorities pointed to large droplets as the key transmission culprits, despite a chorus of protests from researchers like Joseph Allen. Tinier floating droplets can also spread the virus, he and others warned,

meaning plastic shields can't be counted on to stop them in venues like schools and offices where people still breathe shared air. In recent weeks, authorities confirmed such airborne spread. Now, that's not to say plastic hasn't been a useful help in some areas. Plastic makes sense in certain settings, all agree, in front of a cashier who faces many people at close range through the workday, for instance. But our researcher friend Joseph Allen and other indoor air experts

maintain that for schools and offices, money is being best spent on improved ventilation and air filtration, along with masks. And they argue that cleaner air carries benefits beyond COVID for mental function, productivity, and to reduce the spread of other germs like seasonal flu. Recent research found that desk or table barriers in Georgia elementary schools didn't correlate with lower infection rates.

Mask mandates and ventilation improvements did. And finally, although many hospital infection fighters still support plastic shields, once again, this is coming from Bloomberg, some small studies even suggest they may add to transmission by blocking airflow. That raises the ironic possibility that when venues install too much plastic and impede ventilation, they could be contributing to the very risk they're trying to reduce.

So, let me be very clear here. I'm not criticizing this. I think there were all kinds of things that we did when this started because we believed them to be the right thing to do. Knowing that we were dealing with something we hadn't dealt before. This was a new world for most of us. And certainly for businesses and schools and you name it. And researchers were unsure. But the best way to try is to try. And then you determine what works and what doesn't.

And that's why I have no time for those who, you know, haul out the criticism saying, hey, they were wrong about this. They were wrong about that. You know what? You're going to be wrong a few times before you get things right in In some cases, a lot of things they eventually did get right, like masks, which, you know, you heard Dr. Barrett there a few minutes ago. You don't stop using masks right now. Finally, on an upbeat note, i mentioned theaters a moment ago and i can tell you just driving

around stratford and you know stratford's known for the known around the world actually for its festival each year theater festival uh it was canceled last year because of COVID, and indoor stuff is still delayed or canceled this year. But they are trying some open tents. I think I mentioned this a few weeks ago. Hasn't started yet, but the tents are up, and they look fantastic. And there's more than one. I think there are two or three of them in the Stratford area. And they look great.

And they're not going to be able to satisfy a large number of people or long plays, but they are going to be able to, especially on sunny days, it's going to be a fantastic place to be. All carefully orchestrated in terms of distancing and all that. But with, you know, fresh air going through the, I mean, the tents are, they're not tents to the ground, they're tents to above ground. So there is free flow of, they are going through the space. Anyway, it looks pretty neat. And it'll be interesting to see how that works out and how the public responds to it obviously you're not going to want to be out there if there's a

torrential downpour going on um but nevertheless most of the time in the summer in stratford it's pretty nice weather the swans are out the canoes and paddleboats are out on the Avon River. It's a great place to be. And I'm not just saying that because I live here. I'm saying it because it is a great place to be. All right. It's time to wrap it up for this day. Tomorrow, we got a special guest tomorrow. And I'm really looking forward to telling you who that special guest is tomorrow. Tomorrow.

So don't miss it. In the meantime, I'm Peter Mansbridge. This has been The Bridge. Thanks for listening. We'll talk to you again in 24 hours.