The Bridge with Peter Mansbridge - "The Answer is - Shut Up!"

Episode Date: January 24, 2022

It's our regular Monday pandemic checkup, this week with Toronto epidemiologist Dr. Isaac Bogoch.  The good doctor is a straight shooter and he doesn't hold back as the quote above in today's title clearly shows!  But there's a football twist in today's episode as well -- go figure.

And hello there, Peter Mansbridge here. You are just moments away from the latest episode of The Bridge, after the weekend where football and COVID got together. And hello there, yes, Peter Mansbridge here in Toronto on this Monday. As we get ready for our regular Monday, what the heck is going on with COVID and the pandemic this week? And our epidemiologist for this week, Dr. Isaac Bogoch from Toronto. One of the four who we've been using for the last, well, couple of years now to give us a sense of where we are. But before we can get to Dr. Bogoch,

and I know many of you are waiting for this because every Monday you really listen to this particular episode of The Bridge, and for good reason, because these people are fantastic. But I need to give a little explanation, because something happens near the end of this interview that you should be aware of, of why it happens. If you've read my books or heard my stories over the years, you know that I'm a sports fan.

And you can't take that away from a person even in the middle of a pandemic. In fact, for some of us, it kind of saves us through these weeks and months and years. But even back in the day when I used to do the National, as much as people thought I didn't like hockey because it kept knocking us around the schedule, I'm an actually, I'm a hockey fan. And I used to have a little monitor during the playoffs that I could keep an eye on the game

even while I was doing the program, which was, you know, you have to be careful with that, but it was there in case I needed it. Well, I'm also a football fan, both CFL and NFL, and I get, you know, quite worked up at times during the playoffs. I'm a big Tom Brady fan, always have been. But I know that the page is turning and there's a lot of great new young

quarterbacks in Buffalo and Kansas City and Cincinnati. And they are fabulous to watch. So, you know, there's a changing of the guard on the quarterback front. Anyway, what I usually do with these interviews with the epidemiologists, because it's tough to get hold of these people, they're busy. And they're sometimes at the hospital, sometimes at home, you know, juggling family life. And so it's often on a Sunday, Sunday evenings, where I can get through to them and have our chats.

Well, that's what was happening last night when I was talking to Dr. Bogoch. And his window for time just happened to coincide with the end of the Tampa Bay Buccaneers game with Tom Brady. So, you know, just like back in the hockey days, I had a kind of monitor going there on the side, and we do all these interviews by Zoom. And so you can see each other, right? I can see Dr. Bogoch.

Dr. Bogoch can see me. But we're only recording the audio because that's what we obviously use on the podcast and on the broadcast on SiriusXM Canada. So that's the background you need for what eventually happens in this interview. It doesn't get in the way of the main part of the interview. I was going to cut it out and I thought, no, this is real. This is actually what happened and I should share it. And so sharing it, I will So let's get started on this. The issue at hand is, as it is every Monday morning, kind of where we are and dealing with some of the issues that I know you're talking about.

I know you're talking about them because many of you write about them to me. So here's my conversation then it was last night uh with dr isaac boganch epidemiologist university health network in toronto uh advisor to uh to governments and uh sports teams any number of different things he's a he's a sports fan too, when he has time. Here's the conversation. So we're into that kind of crazy situation again where on the one hand we're being told things have plateaued, things have peaked, Omicron in other words. And so things are going to get better in many parts of the country as a result of that. Yet at the same time, we're seeing a lot of governments kind of rushing to open things up. Are we getting ourselves into the same old problem that we've witnessed on any number of different times in the last couple of years?

We might be. It's hard to know. I think it's okay to pump the brakes if things aren't going well. Obviously, you've got to telegraph what's going to happen. You can't just start and stop and start and stop. You have to telegraph what's going to happen a week or more in advance, if at all possible. It's pretty clear that using multiple data sources in much of the country, this variant wave is peaking or plateauing or has peaked. And that's using wastewater surveillance modeling based on the cases that we do have available, looking at the flattening out of ICU admissions and hospital admissions.

And obviously, that's great news, but we still have to remember that just because hospital admissions are plateauing and ICU admissions are plateauing, they're still plateauing at a very, very high number. We still have tremendous personnel issues in the healthcare setting. Omicron is still impacting every sector of the economy and of society. And, you know, it's still great news that it's not getting worse. But obviously, we need it to get significantly better as well. You know, I'm sitting in Ontario. They discussed their reopening plan starting January 31st.

Like any political announcement, there's always going to be a lot of huffing and puffing about this. But if we stop and actually listen to what the plan is, and you listen to the words that come out of people's mouths, it's a plan that spans between late January and mid-March. And paraphrasing here, but again, they're not afraid to pump the brakes, if you need to pump the brakes, the question is, will they if the time comes, but you know, just go gauging by the words coming out of people's mouths that that was, that was discussed, and that's, that's obviously appropriate. So, you know, that's still a week away, we might see a, you know, continued plateau or even a decline in hospitalizations and ICUs over the next week, fingers tightly crossed.

In which case, this might be a very reasonable path. But of course, if you've got to change course, change course. And they telegraphed that, which I thought was appropriate as well. So what should it mean to most of us who are double vaccinated and in a lot of cases also have had the booster? What should it mean to the way we should act now? You know, at an individual level, I think we just have to be honest with people. At an individual level, if you've had three doses of a vaccine, you're probably going to be OK. Right. We know who's at risk for severe illness. And of course, people with underlying medical conditions, people who are frail, elderly individuals, they'll tend to get sicker than others.

But, you know, you look at people who have three doses of a vaccine. Yeah, of course, bad things can happen. But in general, they just don't tend to get that sick enough to land in hospital, to land in an ICU or die. Yes, of course, it can happen. Yes, it does happen. It just doesn't happen with nearly the same frequency of people who, for example, haven't been vaccinated. And again, this is individual level risk. We also have to look at the population as well. You know, we look at the individuals, we look at communities, we look at populations, you know, at a population level, yeah, our healthcare system is completely stretched.

We have so many people in hospital, we have, you know, ICUs that have a lot of cases, and we just have tremendous personnel issues, even if it plateaus, it's just like, you know, people who are underplaying the significance of this wave need to take a scroll through the hospital and you can see how significant it is. If you walk through any emergency department, any medicine ward, any ICU, you will see obviously very sick people, and you will also see staffing shortages, significant staffing shortages. So not to undermine or underplay the significance of this wave, this is a bad wave and we're feeling it. But at an individual level, yeah, if you've had three doses of a vaccine,

you're probably going to be okay. What if you've had three doses and you've had COVID? And I ask that because, as we all know, after this last month, we all know a lot of people who've had COVID. You know, and it's been, for most of them, the overwhelming majority, it's been, you know, three or four uncomfortable days and then moving on. They didn't need to go to the hospital. They didn't even need to go to a doctor. They dealt with it themselves and they moved on. Now, are you any safer if you've had the three vaccines and you've had COVID? Probably. You probably are. I mean, a lot of this is what your immune system has seen. So timing as well is important

as well. We know the timing between exposures, be it exposure to a vaccine or exposure to the virus also matters. But if you had dose one and dose two separated by a couple of months, if you had dose two and dose three separated by five to six months, if you had an Omicron infection somewhere scattered in between there, you probably got some pretty impressive immunity you had dose two and dose three separated by five to six months, if you had an Omicron infection somewhere scattered in between there, you probably got some pretty impressive immunity to this virus. Now, it doesn't mean you can't get it doesn't mean you won't feel like crap if you got it. But you're just really unlikely to get sick enough to land yourself in hospital or die. And again, the whole caveat here is with the variants that we know of that exist, Omicron, Delta,

Alpha, et cetera, who knows what lies in store? Is there another variant lurking somewhere? Of course, there might be. But based on what we know now, if you've had three doses of vaccine and you had an infection and recovery on top of that, you're probably going to be OK. The people who are less likely to be OK, and again, there's no value judgment to this statement, is people who, you know, people have underlying medical conditions whose immune system might be not functioning as well as it might have been in the past. People who are frail, people who are the older end of the spectrum,

you know, obviously, we don't want anyone to get this infection. We can't have this conversation with that, you know, message being partly, we don't want anyone to get this infection. We can't have this conversation with that message being part-like. We don't want anyone to get this infection. It's just that pound for pound, if you've got three doses of the vaccine, you're probably going to get through this infection and recover without having to land yourself in the hospital and get medical care. There's been some talk today in the last couple of days, actually, about another variant that's starting to float around

this BA2. I figure it can't be that serious if they haven't attached a Greek letter to it yet. But what are you hearing about that? You've always warned us that new variants can come. They come and go. And some of them can be pretty ugly as we've just witnessed. Are you hearing? I thought you were going to make the joke. It's all Greek to me, but yeah, I did.

Yeah. I mean, this is, this falls under the Omicron umbrella. So there are, you know, for lack of a better word, a few different family members in this household of Omicron. This BA2 is yet another family member. Is it different than BA1? You know, it looks like it's taken off in some places. I would file this as one eyebrow raised. We'll see if it has any meaningful difference. You know, but, you know, it's really early, so it's hard to speak confidently on anything. But based on what we know now, which of, can change, but based on what we know now, you know, maybe a slightly more transmissible family member under the Omicron umbrella probably has very similar clinical characteristics, probably has very similar protection from vaccination dose one, two and three.

Maybe it's a bit more transmissible, but that's what we know now. We don't really know a ton. Okay. I'm trying to, I'm trying to take all that in as to whether this is something that at this point worries you a great deal or you're just keeping your eye on it. I'm keeping my eye on it. But again, like we have to remember too, what is the wall of immunity that this is up against? We have a ton of Canadians, over 76% of Canadians who have two doses of a vaccine. We have a pretty decent third dose rollout, but significant room for improvement on that. Also, we've got, who knows, I mean, a ton of Canadians, sadly, who have been

infected and recovered from Omicron as well. You know, not to say that this might not, you know, further speed up an Omicron wave that's already barreling through Canada. Maybe it's slightly more transmissible or it slightly out-competes the BA1. But, I mean, I don't quite know how it will unfold here because it still is Omicron. I mean, it just might be a slightly more transmissible or contagious variant within the Omicron umbrella. Get up in your helicopter, if you can, for a minute,

and tell me where we are after two years. What are you seeing from up above when you look down at this thing? Are all the makings there of this, you know, we could actually be watching our exit from this problem? Yeah. I mean, short answer is probably well on route, but not quite there. And obviously, different countries are farther along than others. You know, there's a Canadian context and a global context. From a Canadian context, you know, it's hard.

If you look around, right, the second where we're at, it's hard to say we're doing amazing, you know, when you have such disruption to Canadian society. But having said that, you think about how much worse this could have been if we didn't have the access to vaccines that we did but can you imagine even though omicron has been you know some people unfortunately categorize it as mild which it's not it's milder or a better way of phrasing it is less virulent than the delta variant but that doesn't make it a non-virulent strain. It is. Look at what it's done. We've never had this many people in a hospital in Canada than ever before. So you imagine how nasty this wave might have been had we not had

the degree of vaccination and vaccine uptake in the country. This would have been devastating. On the one hand, you see various sectors of Canada shut down, which is awful to see. On the other hand, it could be way, way worse had we not had this rate of vaccination. So, you know, we've by the end of this wave, we'll have had a ton of people vaccinated with dose one, dose two, dose three, a ton of people who have been infected and have recovered, and a ton of people who have had both vaccination plus recovery from infection. So we'll have a pretty significant degree of community level protection at the end of this wave in Canada. It doesn't mean we aren't susceptible to other waves and to other variants. It just means that perhaps with time, it's just going to impact us

less and less and less when the next variant rolls through town. But of course, we're not an island. And globally, we're doing come si, come sa. The big gap is low income countries and vaccination in low income countries, like that is the obvious elephant in the room that needs to be addressed. Until we truly have a better global campaign and more commitment to the COVAX program and truly enable vaccination in low-income countries, this will remain a significant issue. We will have a higher probability of variants emerging and then spreading throughout the world, just like we saw with Delta variant, just like we saw with Omicron variant. So, you know, we still have a lot of work ahead of us. And a lot of that, it really is the recognition that this is a global issue, not a regional issue. Regions can take steps to protect themselves, but that doesn't completely insulate them. And you've got to focus on global vaccine

equity. Is it just me who's picking up on you doing the, you know, the three shots, the three vaccines or where you used to say, you know, two shots and a booster? You don't use the booster term anymore. Well, no, it's pretty clear that this for adults, at least this is a three dose series it is i mean three doses seems to be the trick and you know there's a lot of other vaccines that have three doses as well right you got hepatitis b human papillomavirus like that's not unique to covid19 it just looks like two doses is really good but three doses is better. Great. You hear maybe some bad faith actors sometimes saying, well, where does it end? I'm going to have dose 12 and dose 13. And the answer

is, shut up. It's a three-dose vaccine series. Let's just wrap our heads around this. Let's try to get three doses to every single person on the planet as best as we can. And then when we move forward, let's think about what we need. Here's the options. Number one, nothing. Maybe we don't need anything else moving forward. Great. Number two, maybe you do need a shot a year just like the influenza vaccine. Maybe you get a shot a year and the next vaccine is a Omicron tailored vaccine that we get, you know, in the late summer, early fall every year. Cool. Okay, fine. Maybe the option is, you need something every two or three years when a variant emerges. Like, the point is, we don't know. But the other point is, we have the gift of time right now to really design good clinical studies. You know, high quality research

should answer these questions. We can't just say, oh, you know what, here's an antibody study. Everyone's getting a fourth dose. I mean, I think that would be ridiculous. You know, antibody studies are helpful and useful

and push us in the right direction, but you need very good quality clinical research to look at what is the true benefit of subsequent doses. So I think there's a lot, we should be open-minded to lots of options.

But what's pretty clear, and there's good data demonstrating that three doses is better than two, okay, that's what the data shows. Let's get three doses to everyone on the planet as fast as we can. Last point, and it's about kids. I know you've got kids and a lot of these – Can you hear them? Yeah. I can hear them in the background.

What are you looking at? You keep looking up. Is there something happening? Is that on my side? It's another Tom Brady just might do it comeback in the works in football. No way. I'm turning this off right after.

Unbelievable. There's only a minute left. Oh, wow. I'll tell you about it but he's he's inside their 10 yard line there's some kind of fingers crossed some kind of big referee decision being made here who gets the ball see what happens why did you postpone this for another half hour because but back then they were down three touchdowns i thought oh no there's no way that they can come back again. Anyway,

that's all right. Let me, um, uh, about the kid situation. I know you've got kids. I know a lot of our listeners have got kids. A lot of our listeners are grandparents with kids who were, you know, under five and who haven't had a shot, uh, because it's not available for them yet. Is that going to change? Yeah, yeah, it is. I mean, there's a ton of research looking at vaccination in the, you know, two to five year old crowd. There was a bit of a setback a few months ago with one of the clinical trials, but I think we'll see some successes on that front. There's other vaccines that we don't have available in Canada, elsewhere in the world where they are vaccinating the two to five year old population. Like this is going to happen and it's going to happen midway through the 2022 calendar year, maybe a little later than that.

But, yeah, I think, you know, this is this is certainly in the in the medium term future. And again, we have to acknowledge that, you know, kids tend to not get nearly as sick as adults, but they still can get sick and they still can land themselves in hospital. And they are landing in hospital with greater frequency, largely related to a massive community burden, but it still happens. And you can reduce that frequency with vaccination. Absolutely. What do you say to somebody who's got a four-year-old or four and a half-year-old and they can't get that shot and they're, they're at school, you know, they're at some kind of preschool. Right. I mean, the risk is there. We're not living in a risk-free world, but I mean, you know, listen, I fully acknowledge that you can line up 20 experts and get 20 different answers here. I'm not, I don't mess around with, with vaccines and

especially I don't mess around with vaccines and kids. I mean, I think you really need to have the data to demonstrate the safety and the efficacy in that age group before you give them the vaccine. So I'm not one to bend the rules on this. You might get different answers from different people, but I mean, in all fairness, we've been living with COVID-19 for two years. I think it's appropriate to wait it out

until you have the clinical studies and NASI, like a true panel of experts. And you listen to what the true panel of experts says. They've been very, very good all along. Maybe, you know, people can argue about how they've communicated some things. But if you look at their content, their content has been fantastic all along. And I'm, you know, inclined to listen to what they say. And I'll leave it there. Another fascinating conversation.

And, you know, thank you for taking the time to have it. And we'll talk again. This isn't going away. It's not going away tomorrow. So I'm sure. Thanks again, Dr. Bogorodj. Take care. Have a good one.

Yep. Bye-bye. You know, I love all our epidemiologists and particularly you know like dr bogach because he has a way with words doesn't he you love that answer the answer is shut up oh yeah dr isaac bogach university health network Toronto, and his take on where we are right now. And I should button up the story on the football game. Brady did come back. He did tie the game.

But then the game was lost in the final seconds when Los Angeles kicked a field goal. Now, as exciting as that game apparently was, including the little bits i got to see the next game which i did get to see was unbelievable and will go in the record books as probably the best game ever played certainly the most exciting in the national football league and that was the uh the game the kansas city uh beat buffalo in the wildest last two minutes. I think there were like 25 points or something scored

in the final two minutes of that game. It was an amazing weekend of football in the NFL. And, you know, the NFL has not been without its problems, serious problems in the last couple of years. But this weekend put the excitement back in football, at least for two days. We'll see how long it runs. All right, we're going to take a quick break,

and then I've got something really fascinating to talk about. It's not about football. It's not about COVID. It's not about the pandemic. It's one of my other favorite topics. You can probably guess what it is, but we'll do that when we come back. And welcome back. Peter Mansbridge here in Toronto on this day.

You're listening to The Bridge on SiriusXM Canada, Channel 167, Canada Talks, or on your favorite podcast platform. We welcome you from wherever you are listening. All right. Long time or even short time listeners know that one of my other favorite topics that's got nothing to do with the kind of news of the day

is about aviation, about airplanes. And because we all may be traveling on airplanes more later this year than we have for the last couple of years, these are good things to know. It starts with a little anecdote about it, something I heard from a pilot. A few years ago, I was flying, I can't even remember where I was flying to, but sitting next to me was a pilot, and we weren't in the cockpit. The pilot was what they called deadheading, was going from one area to another

to pick up a flight that he'd be the captain on. And we were sitting there and, I don't know, we were taxiing and a plane went by with hardly any markings on it. It was basically, you know, metal. It was the, you know, the aluminum or whatever it is that they make airplanes out of, with very few markings on it. In other words, very little paint on it. And then another went by with a lot of paint on it. And I said, is there any actual advantage to having a plane painted? And the pilot said, actually, the advantage is in not having it painted.

And I said, oh, oh yeah why is that he said the weight paint weighs you know there's there's extra weight in paint and there's extra weight in certain colors of paint and so fully painting a plane can add a considerable amount of weight to the plane, which then costs more to fly because it's heavier. You need more fuel. And so the less paint that's on the plane, the cheaper it is to fly. And I said, well, what are we talking about here? A few liters? And he said, no, no, no, no.

We're talking about a lot of money. It can cost a lot of money to have a big paint job on a plane, especially in certain colors. So I've never forgotten that. So that's what I found interesting when I saw this piece from businessinsider.com. And it's about the Boeing 737 MAX. You know, the plane that had all the problems that was taken out of flying. It's now working its way back into the system.

Alaska Airlines and Boeing are using a 737 MAX as an eco-demonstrator. They're trying to find ways to make flying for them cheaper and therefore for passengers cheaper and to have an impact on fuel usage and therefore an impact on climate change, etc. Now, it's a very long article, and I suggest if you're fascinated, and I know a lot of pilots listen to this podcast because I keep getting letters from them. And you might want to look it up, businessinsider.com, because it's quite lengthy and has a lot of things in it. But I'm just going to mention one or two because I think we can all identify with this, but it also gives you a sense of how a little change can have a real impact. You know, if you're out for a walk at night, walking your dog,

or you're on a run at night or in the early morning and it's dark, and you look up in the sky, and every once in a while, you'll see a plane flying overhead. And how do you know there's a plane flying overhead. And how do you know there's a plane flying overhead? Because you see the little light, the red light on the belly of the plane flashing. Right, it's actually, it's not just a signal light, it's a collision light. As if they don't have enough different things

that onboard planes to make sure that they don't bump into each other, that that is an extra added thing the collision light but we would we witness it from the ground and it's kind of neat to look at it and imagine you know where that plane may be going how many people are on it blah blah blah all those things well here's what you didn't know about that little blinking light. It extends about four inches down from the main body of the aircraft, from the fuselage. And it weighs, you know, the machinery inside the plane has a weight to it as well. Not overwhelming, but any weight is more fuel.

But it's the four-inch extension that creates drag on the aircraft, believe it or not, which in effect, I don't know, slows it down or you need more power to maintain the speed you want than you would if that wasn't hanging down. So, you guessed it. One of the things they're looking at is making that light flush with the belly of the aircraft. And the main machinery would be inside the plane

as opposed to dropping outside the plane. Now, the weight will still be the weight, but the drag won't exist. So that's one thing they're looking at. They're experimenting, flying around, and they're trying to determine exactly how much money can you save and how much impact can you have on things like eventually climate change by making a simple change like that. But there's lots more. They're looking at different materials for inside the plane,

different materials that the seats are made out of. So lots of different things are being considered, and I think that's kind of interesting. At least me, the old airline guy i find it interesting um okay let's uh point to the week ahead tomorrow last week if you listen to the thursday edition of the bridge uh there was a great letter from from a fellow who was saying, we need to talk more about the housing situation. Well, we're not going to solve the housing situation on the bridge, but we can certainly try to take it apart and explain it

and try to understand why it's a crisis, what, if anything, is being done about it, and perhaps why not enough is being done about it. So we're going to do that tomorrow with my good friend Preet Banerjee. Preet's a guy who knows a lot of things financial. And he understands money. And he understands how we spend it. There's kind of a personal financial advisor

among other things and he has a very successful podcast of his own. But tomorrow, he's going to be on the bridge and we're going to talk housing. So you might want to listen to that one. Wednesday, of course, Bruce will be here.

Smoke Mirrors and the Truth, Bruce Anderson in Ottawa. And we're toying with a couple of ideas already as to what we might do on Wednesday. Last week's was really very successful. A lot of reaction to last week's Smoke Mirrors and the Truth. Thursday, you know, it'll be some of your reaction to various things. So if you have thoughts or comments or questions, drop me a line at themansbridgepodcast at gmail.com. themansbridgepodcast at gmail.com.

Friday, of course, is Good Talk, Chantelle Hébert in Montreal, Bruce Anderson in Ottawa. And I'll be back in Stratford as of tomorrow. So we'll talk then, I promise. I have done this whole podcast, at least today's portion of it, without looking at a television monitor. I probably would have if Brady had actually won that game last night. I would have watched the highlights over and over and over again.

But we can't knock Tom Brady. He's the GOAT. Greatest of all time. Always will be. Lots of great memories there. All right, that's been the bridge for uh this monday thanks so much for listening i'm peter mansbridge we'll talk to you again in 24 hours