The Bridge with Peter Mansbridge - Inside The Vaccine Rollout - Is Something Seriously Wrong?

Episode Date: January 25, 2021

What is the problem with the vaccine rollout? An expert analysis.

and hello there peter mansbridge here with week 46 welcome to week 46 here on the bridge daily and we've got a i think we've got a pretty interesting podcast for you today that's going to delve into this whole issue of vaccines. And I know a lot of you are kind of wondering what the heck is going on. Where have we bought it? Where is it? When am I going to get it? All these kind of questions. So in a moment, I'm going to have a special guest on who's really going to help us get into this issue and trying to find a guest who doesn't have, you know, an angle or kind

of special interest, the kind of wrong word to use. But so many people who know this stuff are either directly involved with one level of government or another, or a particular vaccine maker. have well heard of in the last little while, but who I think is independent of all of that and can give us a real assessment of where we are on the vaccine distribution area. And I raise it because, well, let me start with the headline today. Today, Monday. Monday of week 46. What's the headline on the Winnipeg Free Press this morning? Well, let me tell you.

I'll tell you right now. Because I've got a copy of it right in my little hand. The top banner of the Winnipeg Free Press today is Manitobans in the dark on vaccines. Well, you know what? You could probably run that headline in any number of local papers across the country, across the continent, actually. The people are kind of in the dark as to where we are on the whole vaccine issue. Manitobans are no different than

the new director of the CDC in the United States, the Centers for Disease Control. This is the director, Rochelle Walensky. She's at the top of her game on dealing with COVID-19 and the rollout of the vaccines, all of that. She's got more information than anybody. What did she say yesterday? She said, I can't tell you how much vaccine we have.

This is the top person overseeing the fight against COVID-19, one of the top people. And she can't tell us how much vaccine the U.S. has? Well, if she can't tell you, then you probably shouldn't feel too bad about being confused about what the situation is right now. As I said, we're going to get to an interview in just a couple of moments. But first of all, let me give you some basic stats,

some figures that we, in fact, do know in terms of Canada today. And these are the figures that are being compiled by those who are doing such things. In terms of how many first doses there have been, how many second doses there have been, how many have actually been received from the manufacturers in different parts of the country,

how many of those have actually been administered. Because overall in Canada, so far only 2% of the population has been vaccinated. Now we got our first series of vaccines in what, mid to late December. And they started doing some over the holidays, but then there was controversy because in some areas, including here in Ontario, they stopped for a while

because it was the holidays. Can't vaccinate in the holidays. That was a mistake. Anyway, they're at 2%. What does 2% actually work out to? Well, over 700,000 first doses, just under 100,000 second doses. As you know, in both Pfizer and Moderna, there have to be, it's a two-dose application, three or four weeks apart.

So of those roughly 800,000 doses that have been given, either first or second, Canada has received 1.1 million. So of the doses that we actually have in Canada, just over 70% of those doses have been administered. Now, I can give you the whole breakdown for each province in the country. I'm not sure that we need to do that Most of the major population provinces are sitting around the national average

Around 2% a little bit higher, in some cases a little bit lower Ontario is only at 1.9% But they're all sitting roughly in the 2% area. So that's where we are in actual numbers. But where the confusion reigns is who's getting what? What are the priorities? When do we expect this to be in much bigger numbers than we're seeing right now?

Those are all key questions, and that's what has people confused. They're confused in their towns. I know to some degree we are here in Stratford. Part of the problem is, you know, every province is different in terms of its regulations. You know, Ottawa makes the purchases for vaccines, then gives them to the provinces to distribute, then each of the provinces makes its decisions,

and then the municipalities are involved in terms of where and how this is all going to happen. So, this is a tricky game. But lives are at stake and people are confused and people want some answers. So that's what we were trying to do today. And that's what we are going to do today. Because our guest is Dr. Zane Chagla. Now you may have heard of Dr. Chagla or seen Dr. Chagla because he's been on a number of television networks.

He operates out of McMaster University where he's a prof. He's an infectious disease guy. But he's really on top of his game and one of the beauties I love Dr. Chagla is because he can really explain stuff so I get it. So I kind of understand it. It's easy for people who are well-versed in the subject to sometimes get carried away in the language. We've been lucky in the different people we've talked to,

including just last week, Lisa Barrett from Halifax. And I got a great letter about her, which I'll read a little later on in today's podcast. Anyway, let's get to Dr. Chakla because this is important. And I think you're going to learn from this about the situation that we're in and how the move forward is going to take place. So here's my conversation with Dr. Zane Chagla from McMaster University. Here it is. Dr. Chagla, if you could use one word to describe the way you think the rollout of the vaccines has been going so far in Canada, what would that word be?

Unprecedented. This is something completely new and unexpected. And so, yeah, there's a lot that's completely novel about this. It sounds like you're being diplomatic when you use that word, because I got to tell you, I spent a lot of the time these past few days talking to people from a variety of different areas. You know, there could be elected officials, it could be frontline healthcare workers, it could be just ordinary people, parents, teachers, some students. And while some of them are saying, well, you know, it is what it is, others are mad. Like they're upset that it's not going the way they thought they'd been led

to believe it would go. No, fair enough. And, you know, I think there are some things that are, again, unprecedented in this. You know, we were talking about these vaccines in November as a potential glimmer of hope. We, you know, had expectations that these vaccines might be available sometime in quarter one of 2021. And we saw vaccines rolling out in mid-December. You know, it is a vaccine that has a storage requirement,

really, that's never been given on a large scale before, particularly the Pfizer vaccine. And like it or not, this is probably one of the most sought after global resources right now in the context of many countries that are tapping the supply of vaccination for their own citizens. And so, you know, I think there is something to be said about all of that in our rollout, understanding the context here. Canada is a small player in this global scheme. It is a

vaccine, again, that has a cold chain requirement that really makes it very unique. And again, we weren't expected to have this until, you know, February or March. All right. Nobody was expected to have it before February or March, right? In other countries, and yet in other countries, things seem to be going more well organized, faster. Not all countries. You know, some are clearly having issues as well. But Canadians like to think, you know, hey, we're at the top of our game.

We're, you know, we're smart. We've got the players. And it doesn't seem to be happening at all the way they thought it was going to happen. So where are we falling short, if you will? I appreciate, and I think everybody appreciates, the unprecedented nature of this. I mean, a year ago when this started, you know, we were being told it could be five or ten years before we get a vaccine. So, okay, we get that end of it, but what's not going right here? Yeah, I mean, I think there were some issues with that initial implementation and where the vaccine actually was going.

We were handcuffed with the fact that the Pfizer vaccine had this cold chain requirement, and the manufacturer was very clear to say it had to be in the ultra-cold fridges, and it couldn't move outside of those fridges. It only came down a week or two later that they were much more generous with that, and I think Israel had proved the example that you could take it well out of the fridges and put it into arms that were not near the sites of distribution. And so, you know, I think where we started putting the vaccines was reasonable. You know, Toronto and Ottawa, the test cases in Ontario,

the major cities across Canada were their own test cases in the provinces. But then we started getting into the weeds of who to give it to and how fast to implement it. There were controversies about clinics that were closed. There was this huge effort to, say, put needles into arms, stop holding back the second dose. And some of that was very reasonable. But there were supply-demand mismatches where a huge amount of were, you know, supply demand mismatches where, you know, a huge amount of vaccine, for example, went to the Atlantic's where, you know, I think they deserve to have

some vaccine for some of their higher risk environments. But knowing the burden of disease that was ongoing in other places in Canada, you know, the whole point of this vaccine effort for whatever privileged supply we had up front was to get it into arms where it's going to make a major difference. We saw health care centers, and I think UHN is an example, where people who were not necessarily the highest, highest risk were getting vaccines. And, you know, a more concerted effort to actually, you know, if you get down that first rung of people intentionally you want to vaccinate, to start reaching out to your greater community rather than starting to go internally and say,

who else needs to come here from the highest risk, from community hospitals, from community partners, from shelters, from long-term care, and making sure that they're involved. And, you know, I think the other part is with the, you know with the general fervor of making sure that, you know, as many doses get out of fridges into arms, there was an over trust of the system that the supply chain was going to be maintained. You know, again, this is the biggest global asset of them all. Every country is clamoring at this. Everyone wants to protect their own citizens to not expect that there would be a lot that would have an issue. There would be a shipping error. There would be a recall. You know, all of these things that happen in normal drug manufacture. You know, now we're dealing with the supply chain issue without any real contingency for it and the looming specter that people need to be given their second doses.

And unfortunately, that's throwing a giant wrench in the plans is around the time we're getting second doses in where we need a stable supply. You know, it's being taken off the table and maybe a little slowing down to make sure that people had the opportunity to get a full vaccine series, particularly those that count in terms of long-term care and those over the age of 80. Did we buy the right stuff or, you know, maybe to put it more correctly, did we buy the right stuff under the right conditions? Because it seems like, you know, where you are in terms of the delivery system isn't just what you bought. It's kind of the conditions that were applied to

that purchase as well. Yeah, I would say it's more logistics than conditions. You know, Quebec was a great example where they took, you know, the ultra cold fridge requirement. And rather than dealing with the fact that these ultra cold fridges are in academic health sciences and research centers, they put them directly into long term care facilities and started using that as the center for immunization. And I think that's that's novel in that sense. You know, there are a ton of ultra cold fridges across the nation, and they were bought. And so I don't think the actual storage and the actual physical infrastructure was the issue. But yeah, it was the logistics. It's how you enroll people. It's how you captured who needed to get done and implemented it as fast as possible where we dealt with issues and human resources on the back of healthcare workers being pulled in every

direction possible and not tapping into as many community resources as possible to get clinics up and running, even for healthcare workers in long-term care. You know, I think it's more the human side of things that may have gone wrong in that distribution and not optimizing, you know, how the doses were distributed. You know, a lot of people have referred to, and you did just earlier, how successful the rollout has been in Israel. And, you know, I love Israel and good for them that they've done a good job, but it is a different country.

You know, we're a much bigger country and we're layered with these different provincial jurisdictions and rollout procedures and who gets it. How complicated or how difficult has that made it in terms, not just the size of our country, obviously, but also the different layers of jurisdiction? Yeah, absolutely. I mean, again, Israel is a great example of a country that's small, that has, I mean, probably one of the arguments, one of the world's biggest logistical networks per capita in terms of its militaristic support. And so they were able to really, you know, enhance the process and really went bluntly at saying,

if you're over 60, come and get vaccinated. And we're just going to do this in large scale as big as possible. But, you know, Canada is multiple layers. You know, the federal government is doing the provisioning. The distribution is falling on the provincial government, local health authorities are trying to balance their long-term care as well as their healthcare workers, and also lobby to the provincial government to get more doses, particularly in cities that are not necessarily the big ones. And I know a few in Ontario where they've really, really had to push to get doses into people as they've been forgotten in some of the larger cities. You know, it creates so many of these layers.

And again, at the end of the day, when there's a supply chain disruption, as we're seeing, it ripples down to all of those layers and everyone has to scramble at the same time. It's not coordinated. The supply chain now is coming from the federal government. It's going down to the provinces who are not getting much of an allotment and saying whatever is coming in, we're going to put directly into long-term care and people getting their second doses. And us, you know, on the front lines who are developing vaccine clinics, who are trying to get their healthcare workers vaccinated as well, are kind of saying, you know, four or five days later, you know, we're completely disrupted and have to stop on a dime knowing what happened at a top level. So obviously that coordination is important. But, you know, again, that's the implementation.

There are thousands of healthcare workers across the country and no way to register them correctly other than at the local level. And so there are going to be gaps and there are going to be people that are vaccinated that shouldn't have been vaccinated and people that should be vaccinated that aren't getting vaccinated. Wow. You know, others have raised this issue about, you know, are we using the right people with the right expertise to handle some of these logistics? You know, like, why aren't we using, you know, proven delivery systems like, you know, Amazon or Indigo or what have you that can get you a book in a matter of hours to your community no matter almost seemingly wherever you live. And also drugstores in terms of doing the actual vaccinations

that can be open 24 hours a day, et cetera, et cetera. Is this all something that sort of like slowly gets worked out or are we missing the opportunities that exist for people who can do certain things better? Yeah. I mean, so public health units have been engaged and I think there are these stakeholders. I mean, public health units are, local public health units are the fundamentals for vaccination in the community. And so they have been engaged. You know, I think in my own jurisdiction, our efforts have been directly through public health, both with health care workers and long term care sector.

But I think it's it's also important to know exactly what goes into distributing this vaccine. So as many people think it's just a truck that goes in a fridge and then a bunch of people drive the vaccine and then delivering it. But it's so much more than that. Remember, there needs to be police presence to deliver these vaccines because there's a large security spread on them. Similarly, all the IT systems that are associated with these vaccines need to be guarded against cyber threats. And realistically, as much as you're collecting patient and provider data around it, there's a big hole there in terms of security. You then need to make sure that it's handled correctly so you're not spoiling doses.

And that has happened in Canada multiple times. You have to register people appropriately in the context of not, you know, a mass vaccine clinic where everyone can go into a gymnasium. You still have to consider that COVID is around us and we don't want to spread it in a distribution center. You have to track people appropriately. You have to track adverse effects appropriately. And so, yeah, I mean, you know, there are a number of steps here, especially with this small rollout of, again, predominantly long-term care healthcare workers and at risk,

where you have to rely on, you know, very robust networks, not just, you know, the Amazon service, but the security, the pharmacy, the, you know, the infection control, the monitoring, and the logistics more than that. I 100% agree, though, as we, the infection control, the monitoring and the logistics more than that. I 100 percent agree, though, as we get better at this, as we have more supply, that more networks need to be engaged. And primary care is the big example here where, again, they are the groundwork for vaccination in the community. I don't think anyone doesn't expect that people will be getting vaccines through their family doctor at some point or another in the next six months. Right now, though, with the logistics in the supply chain as it is, you know, for the most part, we are getting more demand than supply.

I think there's not really that much wastage. It's hard to scale up when you're in that scenario. You can innovate, you can try to bring in models. But at the end of the day, what happened in Toronto at the convention center, you made a great clinic. It had to close down because there's no supply. And so there's a limit here to what we can do. Okay. Last question. This has been great.

You've been fabulous in explaining the kind of inner workings of how all this is happening. Kind of like the first question where I asked you to use one word. When you look at the situation, given all the complexities of it and all the ups and downs that it's having, are you optimistic or pessimistic or somewhere in between? Yeah, I'm optimistic. Look, you know, it is obviously tough to see people dying in long-term care that could have been vaccinated a few weeks ago. And, you know, there was never going to be a scenario where that wasn't going to happen. If the vaccine was delivered in December, January, February, or March, we are

dealing with outbreaks in long-term care. And unfortunately people will die before they get it. And that's, you know, an unfortunate thing, but at the same time with whatever limited supply we've had, you know, many, many provinces, many major urban centers have been able to get a first dose of vaccine into their long-term care residents. Knowing 70% of our deaths are from there, you know, that is hope. If you can prevent 70% of deaths in two to three weeks when people get their second dose and are fully immunized, this outbreak is going to look very different in a few weeks once that's established. Yes, we don't have the supply to do it in every long-term care facility, but certainly the hardest hit. And I think as you start seeing these effects, how profound they are in long-term care, start working themselves out in the next few weeks, we are going to be more and more hopeful and optimistic. There is going to be doses coming in.

Pfizer will be delivering. Moderna will be delivering. There is Johnson & Johnson on the horizon in terms of what their data shows in AstraZeneca that's still working themselves out. You know, the fact that most Canadians will probably have access to a vaccine by September and that our most vulnerable will be protected at some point in the next few months, I think there's certainly hope on the horizon for something that, again, we didn't predict. We said 18 months, and really this is 12 months since, you know, the epidemic hit us hard in Canada. Dr. Chagla, you've really helped us understand the situation the better. We do appreciate your time. No problem. Pleasure.

Okay. Well, I hope you, I hope you got as much from that discussion as I did. And I really appreciate Dr. Chagla, as I said, taking the time to talk to us today to try and help us through this maze on the issue of vaccines. I mentioned just before we went to the interview that I got a really nice letter about last week's conversation that we had with Dr. Lisa Barrett from Dalhousie University in Halifax. And it was about, you know, she's the same. She's an expert in this area.

But the discussion was really about why Atlantic Canada, Nova Scotia in particular, has been doing so well in terms of the fight against COVID-19. Touch wood, it keeps that way. So anyway, I get this letter over the weekend from Jill Snell from the other end of the country, from Fernie, British Columbia. And this is what she wrote. Thank you for another engaging and entertaining week on the Bridge Daily. You had asked for the one line that would stick in memory this week. Although it was a historic week, bringing many highlights, the words I will remember most came from your conversation with Lisa Barrett on Tuesday. First and foremost is, we are not backing down on the idea of masking, hand-washing, and distancing,

despite bringing in additional layers of protection through testing and vaccine. There were so many more, but this must also be highlighted. Nothing is possible without engagement of people. Nothing is possible without science of people. Nothing is possible without science and innovation and a consistent message. I think that sums up how we should have been dealing with this pandemic. Thanks for bringing her on and thank her again for her time and efforts. May we all go forward being a little more like Nova Scotia. Yours in health and hand washing, Jill Snell in Fernie, BC.

Thanks, Jill. And I'm sure Lisa Barrett will appreciate your kind comments as well. Now, you know what it's like here at the bridge. We like to try and leave on something positive. I don't know if positive is the right word, but something that will either make you smile or make you feel confident in the future. Well, I saw a piece the other day in the New York Times. And it was the kind of annual piece.

I can remember these for years. I remember even being assigned it once when I was a local reporter in Winnipeg back in the 70s. Go do a piece on who the favorite choices for names are for new babies. That seems to be kind of a January story, you know, like first baby of the year. And then the backup is, what are the popular names this year? So that's what this is about. Now, I remember when Cynthia and I named our son, Will,

we didn't, it was a pretty simple process. We both lost our fathers. Well, actually, Cynthia lost her dad. And I was about to lose my dad a couple of years after Willie was born. But we decided to dedicate Will's names to our father's names, his grandfather, in each case.

So that's how he became William Stanley Mansbridge. William after his grandfather on Cynthia's side, who just passed his first name. And then my dad, Stanley, who would live a few more years after Willie was born, as the second name, William Stanley. So that wasn't hard. That was pretty straightforward. But some people go through agonizing debates and discussions

and time to determine the name they're going to have for their child. And you may well be one of those people. So apparently, according to the research done by Jancy Dunn at the New York Times, one of the popular things this year to be doing is trying to find a name that has positive connotations. As a result of the troubles we've been through in the last year, how are we going to look forward to the future? We're going to name our kid after something positive. And she tells the story of Sierra Armstrong,

who works in the service industry in New Orleans. and she tells the story of Sierra Armstrong, who works in the service industry in New Orleans. She said that she and her partner have named their newborn daughter Cameron. That's Cameron with a K, K-A-M-R-Y-N. The Scottish root of the name, originally spelled Cameron with a C, means crooked nose. And you go, excuse me, how is that positive? But, says Sierra Armstrong, and she's got a great first name, Sierra.

But, says Sierra Armstrong, I saw somewhere that in the U.S. it means a gift from God. And I loved that. The virus nudged the name to the top of her list because life is a gift, she said. The whole world is in flux, and I'm glad I'm healthy and whole and so far haven't gotten COVID. When you're able to get up each day and continue on, that's a gift itself. So, what are some of the other names, you ask, and I tell?

Views of the name Zora, Z-O-R-A, for example, which means dawn, and suggests new beginnings are up 40%. This is on one of those websites where you can look up the name and what it means. Alma, A-L-M-A, or Alma, means soul in Spanish. It's up 37%. Lucius, L-U-C-I-U-S, which connotes light, is up 24%. Other risers include Vivien,

from the Latin root vivus, meaning alive or lively, Aurora, the Roman goddess of the sunrise, Felix, that means happy, Frida, means peaceful. And Zuri, Z-U-R-I, means good in Swahili.

Place names such as Cairo and Milan are also on the rise, perhaps reflecting a longing to travel during the lockdown. Funny, you know, I don't see Peter on that list. Okay, if those are all the names going up, what's going down? Come on. What do you think's going down as a name choice? You can do this.

Think it through. That's right, Donald. Donald is sinking. Near 2000, it was number 217, says one of the people interviewed for this article, the New York Times. Near 2000, it was number 217, and it's not on our charts in 2020. And we do the top 1,000 names.

It's not any of them. And for the time being, we can probably forget Corona. Very pretty. Latin for crown, said one of the people interviewed. Not happening. I guess not. Who'd want to be called Corona this year? I don't think so. All right. That gives you something else to think about. On a day when our major focus was on vaccines and the confusion and the fact that some of us, like in Manitoba, are in the dark over this,

of what's happening. I hope we've spread a little light for you on it. So that's our welcome to week 46. That's our Monday broadcast podcast. The week will unfold as it always does. Wednesday, of course, is Smoke Mirrors and the Truth. Bruce Anderson will join us from Ottawa. We haven't picked a topic yet, but I'm sure there's never a problem to find one.

Friday is the weekend special. And on Tuesday and Thursday, who knows? I've got some ideas. We'll see what we end up doing, both tomorrow and the rest of the week. I know some of you have been asking, you keep saying you're going to announce how the podcast is going to change a little bit. I am going to announce that, and I know it's taking a little longer than we're supposed to. Basically, the deal's all done, but we're just finalizing a few things. make this happen in terms of the technical issues surrounding doing this podcast from home and yet launching it up on a new organization and ensuring that you don't lose it in the process. And that's

obviously one of the key concerns that I had. It's going to be available now on a number of platforms. It's become, thanks to you, a very popular podcast. And as a result, those that I'm working out this new arrangement with are really anxious to see it available to as many people as possible. And they have some interesting and unique ways of doing exactly that. Hopefully we'll be able to announce all that this week. Should be starting, we'd hoped it would start by the early part of February, which is not far away now. And hopefully that will still take effect.

But for you, you should still get it exactly the way you're getting it now. There's going to be a few different things in terms of the sound of it all. But basically, the podcast, the principles behind it will still be exactly the same as they are right now. And I will retain editorial and content control. So basically it's going to be very similar to what, what you're listening to now. Okay. Enough babbling.

I'm babbling. Time to call it a, call it a day. That is our Monday podcast. I'm Peter Mansbridge with The Bridge. Thanks so much for listening. And as you know, we'll be back in 24 hours. Thank you.