The Bridge with Peter Mansbridge - We Could Have Four Different Covid Vaccines Very Soon -- Then What?

Episode Date: March 1, 2021

Last week there were just two, now three, and maybe four within a week.  We're talking vaccines -- and how could that change everything?  Infectious disease specialist Dr. Isaac Bogoch is our guest.

and hello there i'm peter mansbridge you're just moments away from the latest episode of the bridge where we talk vaccines this week there are three next week there could be four And hello there, Peter Mansbridge here. You know, I was just looking at my century-old calendar. And the month has flipped over to March. Here we are in March. Remember when this all started? It was March. You know, about a year ago today or yesterday, I flew back from London's

Heathrow Airport. I'd been over in Europe for, I don't know, about a week. I'd been in the Netherlands. I'd been in Scotland. I'd been in England. And I was kind of puzzled on that flight home because depending on where you were and who you were looking at, there was quite a trickle of people wearing masks. And the little mass debate had kind of started, but for the most part, people were saying, oh, you know, you don't, it's probably preferable, but you don't really need to wear a mask. Now, I didn't wear a mask, but I was puzzled, especially on the Air Canada flight coming back from Heathrow to Toronto,

that some flight attendants were wearing masks, others were not, which was considerably different than the week before when I'd gone over when nobody was wearing masks. So we were in a period of some change. And boy, change came in a hurry after that. When I got back to Canada, I was actually planning to head to South Africa a couple of days later. But that got caught in the crunch. As governments started to move in, stopping travel,

stopping people from coming into the country, stopping people from going out of the country, not so much the latter, but certainly the former. And then, boom, things hit with a force, and we were into it. And by the middle of March, for most of us, our attitudes changed on a lot of things. You know, we became more caring. We became more observant.

We started to follow the rules, most of us. We understood what an essential worker was. And it wasn't what we used to think an essential worker was. We suddenly had a much greater respect for those people who work in grocery stores, for example. Certainly for frontline healthcare workers, postal workers, garbage collectors. The people who clearly were essential for the way our lives were to unfold. While most of us followed the rules and stayed at home, essential workers had to go to work. And we will forever be indebted to them.

We, when I talked about caring, you know, we worried about our neighbors. We worried about our parents and grandparents. All of that started happening in a big way in March of last year. And I don't think any of us at the time really suspected that still by March of this year, we'd still, for the most part, be in the same situation. But we are. Although there are hopeful signs on the horizon.

There are worrying signs on the horizon still, the variants. But the hopeful signs suggest we may be slowly, gradually coming out of this. And one of the great helps, of course, are the vaccines. As I said, last week we had two vaccines, Pfizer and Moderna. This week we start to have three with the addition of AstraZeneca. And it's almost certain that we're going to get a fourth within the next week or two in Johnson & Johnson. So in a couple of months, we've gone from zero vaccines to four.

In a year, we've gone from being told it could take two to ten years before we get a vaccine to getting four. And there are going to be more. So what does it all really mean that we're getting more vaccines does it mean that those of us who haven't been vaccinated yet which is the overwhelming majority couldn't look at a better timetable for that you would think so but really is that what's going to happen? Well, I can't answer those questions. But one of our regulars on the bridge can. And so we're calling upon, as we often do on Mondays, we call upon one of the infectious disease specialists that we regularly talk to.

You know them. They're in Halifax, Edmonton, Toronto, Hamilton. And today it's Toronto's turn. That means Dr. Isaac Bogoch at the University of Toronto, infectious disease specialist, works in hospitals, works on helping on the rollout of the vaccine in Ontario. And there have been controversies around that, as you know. But Dr. Bogoch is not shy about telling us exactly how he feels.

He hasn't been in the past, and I'm sure he won't be today. So let's try and get a sense of what's really going on, on the vaccine front, with Dr. Isaac Bogoch. All right, so we've got three vaccines now, and a fourth one could be coming, I guess, almost at any time in the next week or two. How does that number change, basically, the situation that we're in? Yeah, it's amazing. The third vaccine, the AstraZeneca vaccine, certainly a welcome addition. Basically, it just amazing. The third vaccine, the AstraZeneca vaccine, certainly a welcome addition. Basically, it just speeds everything up. We just have access to more

vaccine and also it's a versatile one. So it's one that doesn't require that same minus 20 or minus 80 storage that the Moderna and Pfizer vaccine needs. It's just a versatile vaccine that works. So speeds up all of those timelines and also makes it easier for people to get it so i mean you can administer this for example in primary care clinics you can put this in uh mobile units to vaccinate homeless or underhoused populations there's a lot you can do with this product and what about the other one johnson johnson if it comes in because it seems to be a feeling that it, it could be a week or two weeks away and not much more than that. Win a, win a chicken dinner,

as they say in Boston, like that's an amazing vaccine, right? It's a one shot deal. It's like all of these vaccines do what do the same thing in the sense that they significantly reduce your chance of getting the infection, significantly reduce your chances of having a severe infection if you do get infected. And of course, there's been no deaths in anyone who's got COVID-19 and had these vaccines.

So they all do the job. The Johnson & Johnson one would be phenomenal, though. Just imagine the efficiency of vaccination when you don't have to bring people back for a second dose. It's just, it would be a very very helpful tool the question still seems to be in this country about getting the first dose even if the vaccines are actually there i mean are we ready for this sudden you know upping of the game in terms of the number of vaccines that are going to be coming into the country we are we are and if you look coast to coast you can start to see the early signs of these programs ramping up.

I can speak about Ontario because I'm in Ontario, but you don't have to look too hard to see what the public health units are doing in the various jurisdictions of Ontario to mass vaccinate those that they represent. And in fact, almost all of the public health units have their plans transparent. They're open. They're on their websites. You can scroll through it. But you can see there are mass vaccine sites and usually several of them throughout the public health units. So they can really get through as many patients as possible, as many people as possible and vaccinate a ton of people every day. In addition to that, you at least in Ontario and I know in many other parts of the country, pharmacies will be vaccinating as well. And you just imagine how efficient a system that is to get a ton of people vaccinated. And I think when we have more products like AstraZeneca, perhaps Johnson & Johnson and Novavax that don't require that deep freeze, you'll start to see more primary care providers vaccinating too. So I am confident

that when we do truly have access to more vaccines, we are in a position where we can really ramp up the program. Currently in Ontario, we're vaccinating about 25,000 people per day on a good day and just watch that number climb much, much, much to what i mean what would be much much higher i think it will be north of a hundred thousand per day um but a lot like a lot a lot i have to actually do the math because if you go into all the public health websites you can see how many people per day they can vaccinate through their clinic. So, for example, the mayor of Brampton was talking about the Peel, just Peel region alone in Ontario, and he was saying when they get going,

they can vaccinate about 40,000 people per day in Peel alone. Here's the next question, and you've heard it tossed around a little bit this weekend. I go in to get my vaccine. I finally get to the front of the line and while this is unlikely to ever happen let's just say it does happen you get to the line where's this going you know you know where it's going the guy's gonna say or the woman's gonna say okay well we actually have three different vaccines here which one would you like what do i say you say whatever one you have available first of all that's not going to happen right let's be clear that is not happening anytime soon we still have a shortage and and we still

are rationing limited resources um i think that might be there may be a time, maybe a time much, much, much later on, like summer, late summer, perhaps, where, you know, if you go to place a, for example, like a mass vaccine site, they'll be giving Pfizer vaccines because that's just more suited to a mass vaccine site. Whereas if you go to place B, I'm making this up, let's say a primary care clinic, they might have Johnson and Johnson, for example. So maybe maybe later on, you'll have a choice as to what vaccine you're going to get. And it'll likely be determined because of where you're getting the vaccine and which vaccines are more suitable for delivery at these different locations. Currently, that's not the case. And also currently, I think we should also remember what it is these vaccines do, right?

We often are trying. I think what you're really getting at here is we've seen 94 percent efficacy with the Pfizer and the Moderna vaccines. And, you know, 60 something percent efficacy with with AstraZeneca and Johnson and Johnson. And, you know, I think we have to remember a couple of things. One is that that difference is not as profound as those numbers suggest. So the Pfizer and the Moderna vaccines were really tested in an era where there weren't that many variants of concern that were around at that time, whereas the other vaccines were tested in the era where there were significantly more variants of concern. So the delta, the difference between those efficacy values is smaller than what the published numbers suggest. That's the first point.

The second point is there still probably is a delta, like there probably is. But the other thing we should be looking at is what is the role that these vaccines prevent serious illness, hospitalization, and death? And the answer is they all do, and they're all very, very well prepared to do so. The last point is when you just look at real world data, for example, let's take AstraZeneca, real world data from AstraZeneca. There's some great data coming out of Scotland where they've actually had millions and millions of people. Tell us a breeze. It works. It works. And the risk is extraordinarily low that people will get the infection and is basically non-existent that people get sick and die from this infection. So there's great clinical data and then great real world data

suggesting that all of these vaccines are just fine. The real answer is don't wait, vaccinate. I just made that up, but really it's just like, whatever comes your way, it's a good idea to get it. It's also good to remember too, that this isn't the last vaccine that people are going to get. We are all going to need a booster shot or an updated vaccine that accommodates the variants of concern. So, you know, people who are getting, I'm just making it up. Let's say someone gets a Johnson and Johnson, but they really wanted a Moderna. Well, you can still get a booster. You're very likely going to get a booster shot later on. I'm not,

I don't know when but it may be the tail end of 2021 or early 2022 we're all going to get another vaccine at some point the the you know i've read stuff in the british newspapers where there's a resistance or at least there was a week or two weeks ago um to the homegrown variety which was which is astrazeneca because of the uh of that i guess a degree of confusion around the efficacy rates and what they actually meant and and the the desire was no no i don't want that one i want a pfizer and they were actually getting this oh pardon me yeah i mean they were actually getting people they were actually getting people canceling their appointments

they're not turning up for appointments because they found out it was going to be AstraZeneca and not Pfizer. And you're saying, well, that's a communication problem. It is, it is. So there's a word of this happening in Germany as well. And I mean, I've got my ear to the ground in Canada and there's chatter of that happening here, especially among certain communities and particular communities.

So this truly is a communication failure. Like it really is. We are pitting vaccines against each other and saying one's 92 or 94% versus 60 something percent. The message should be, they're all 100 percent effective in the clinical trials at preventing hospitalization and death because they are. That should be the message. And that's open, honest, transparent. I mean, that's the real message, right? This is

what they do. They're fantastic. So I really think we need to do a better job at messaging what exactly these vaccines do and also their outcomes, not only in the clinical trials, but also in real world settings. The Scottish data is fantastic for the AstraZeneca. The Israel data is fantastic for the Pfizer. Like we should really be talking about what they do in real world settings and demonstrate how they have a profound impact on an individual and of course on a community as well you know when you say um being open honest and transparent i you know i always believe you are when we have our discussions and i don't have any problem with that um so let me ask you a direct question looking for that uh openness and honesty and transparency i mean you you are involved uh in an advisory role on the with the ontario rollout on the vaccine um has it been handled as well as a could have been handled

in ontario i think yeah i think there's there's been obvious missteps along the road but i also think that some of the missteps have been amplified to be a 10 out of 10, when in fact, they're probably a two out of 10. But you know, for example, number one, there was a Christmas slowdown of vaccination. Well, that's inexcusable. Why would you stop vaccinating on Christmas, especially when you've got new vaccines that need to go into arms, right? There was certainly a slow start to the program as well. And in all fairness, I give the program, I mean, I'd say give it a couple of weeks to at least get launched. But after that two-week mark when we were launched, it was still too slow. It was still too slow, even after about a two-week

wiggle room to sort of get that rust off. It was still too slow for a bit. And then it took about five or six days to really get up to speed, where based on the vaccines that were coming in, they finally got up to about, I don't know, 15,000 per day, which is pretty reasonable based on the supply that we had. I think we could have vaccinated the long-term care sector faster, but all things considered, there were some challenges. And again, some of the challenges i think were over uh maybe they weren't appreciated but there were significant challenges in vaccinating long-term care uh while some people said it could have been done much much much faster i think it could have

been done faster but not as fast as some may may have said for i don't know if we need to get into it here so yeah obviously there's there's clear hiccups along the way and i would say there's been communication issues as well here and there too that have uh caused a lot of concern and alarm uh but also on the other hand you know vaccines got into the province and vaccines were delivered and you know the state the phase one at the end of the day everyone in long-term care who's wanted a vaccine has basically got one they're almost finished vaccinating the second group uh many community elders are now over the age of 80 are starting to get vaccinated even before a central provincial uh website goes up that's happening there's been some excellent advocacy and because of sadly people experiencing homelessness and shelters uh have had notable outbreaks that have really driven.

It's actually just basically driven a lockdown in Thunder Bay. And now we're vaccinating homeless populations and shelters. So, like, there has been a lot of malleability and flexibility when you would think that there's little room for that in this big lumbering government system. But there has there has actually been and i think there have been some real successes so uh yeah of course room for improvement but also some some real successes as well let me just ask you one more question and i ask it because i got a couple of letters uh emails this weekend from uh listeners who who are puzzled by this because they're not quite sure the advice they're getting when

they hear different places. And that is getting the vaccine if you're pregnant. Oh, love this one. So in the clinical trials, pregnant individuals and people who are breastfeeding were not included. And that's a huge problem, like well outside of COVID-19. Like we should be including pregnant individuals and lactating individuals into clinical trials, but they're not. So you can't look someone who's pregnant in the eye and say, this is 100% perfectly safe. But on the other hand, when you look at how this vaccine is made and what this vaccine does, why, of course, why wouldn't it be completely safe? Of course, we don't have data to

back this up. So there's a couple of points here. The first is that there's registry data now with people who have been vaccinated, who are pregnant and breastfeeding, who are included in these registry trials to demonstrate that it actually is safe. In addition to that, there's now a prospective study that's underway looking at pregnant individuals being enrolled in a trial and following them prospectively to determine the true degree of safety of these vaccines a severe illness in pregnant individuals. It can compared to the general public. The days of paternalistic medicine, hopefully are long gone. It's not my business as a physician to tell a woman who's pregnant saying, no, you can't have this. And we're seeing this reflected now in the documentation and in the consent form. So now in Canada, of course, in Ontario,

if you're pregnant or you're breastfeeding, no one can say you can get this vaccine. Of course, you can get this vaccine. It's no one's job to say you can't get this vaccine. None of our business. But you just have to have a conversation. And and that conversation is listen we we don't have data from large clinical trials um here's the risks here's the benefits here's what we know here's what we don't know and you can make an informed decision over your for over your body whether you want to do this or not and you know in uh you always have to get skeptical when someone says in my experience but in my experience many pregnant women are getting this vaccine many people are breastfeeding are getting this vaccine and that's okay as long as

people are making informed decisions for themselves okay we'll leave it at that for uh for this week isaac bogach as uh as always your time is extremely valuable um for your normal job and it's extremely valuable to us to get a chance to listen to you as well so thanks so much my pleasure have a great day and you know all i can say for all the infectious disease specialists that we talk to on a regular basis and always mondays it seems um their time is like so valuable and so extremely important for the work they're doing. And that they take time to talk to me and to talk to many other journalists who are just simply seeking information.

I mean, in the old days, we used to go to the politicians. And, you know, to some degree, we still talk to them. But these are the front line. These are the scientists, the are the scientists the researchers the doctors the nurses um who are right there who are dealing with this every day and are having to make critical decisions every day they know their stuff and uh certainly we've been lucky with uh with doctors like isaac bogoch um that he would spend some time with us, usually from his home in between moments with his kids

and moments at the hospital or moments at the university. He's a busy guy, but he's never said no, and he's always found time to talk to us and to talk, as you know, if you watch or listen or read any other media, he talks to many. So I deeply appreciate the time spent with all of our infectious disease specialists and today with Dr. Bogoch.

All right. Still to come. You losing your hair. I know what you're thinking. You're thinking, Mansbridge, you lost your hair a long time ago. Well, it's not all about me. Believe it or not. I'll get to that in a moment because it's pretty interesting.

And it fits in the whole COVID story. But first, do you ever, you know, I'm assuming that you use your computer, your laptop or your phone fairly often and you're sending messages and sometimes you're sending messages on social media and sometimes after you've pushed send, you go, did I really want to push send on that? Did I maybe kind of step over the bounds in what I just said? Well, this has been a constant. We've all done that at some point. Wish we hadn't sent what we sent. Tweeted something we wish we hadn't tweeted.

You know, sometimes I get a little carried away in the rivalry between the Leafs and the Habs. I say things about the Habs, who fired their coach, who were on a losing streak, that I probably shouldn't say. Because they're the Habs. They'll be back, and you just know it.

But some of these things that happen when you shouldn't have pushed sand are much more serious than sporting situations. Well, I found it interesting to read, because Twitter has perhaps been under the gun as much as anybody perhaps only short of facebook for the way they conduct business and that they should be coming up with safeguards to prevent the kind of online harassment that happens well i see Well, I see from a website called TechCrunch that Twitter is running a new test right now

that's asking users to pause and think before they tweet. What a concept. According to the company's announcement, when Twitter detects what appears to be a potentially harmful or offensive reply to someone else's tweet, it will prompt you to consider revising your text instead of tweeting. The article says users whose tweets are flagged in this way will see a pop-up message appear on their screen which asks, Want to review this before tweeting? are flagged in this way. We'll see a pop-up message appear on their screen which asks, want to review this before tweeting? There are three buttons to then choose from, one to tweet the reply anyway, an edit button, and a delete button to discard the tweet entirely. There's also a small link to report if the system got things wrong. Well, that's interesting.

I haven't seen it happen yet. They obviously don't mind ragging on the abs. But this is helpful. This gives you that second opportunity to rethink what you were about to say. And according to this article, it's been shown that these sorts of built-in small nudges, as they call them, can have an impact. For example, when Twitter began prompting users to read before retweeting, the company found that users would open the articles 40% more often than without the nudge. So, you know, you see some article

and you immediately retweet it based on just the headline. And Twitter says, why don't you actually read this before you retweet it? And 40% did. Twitter's also built similar experiments to try to slow down the pace of online conversation on its platform by doing things like discouraging retweets without commentary or to slow down likes on tweets containing misinformation. And that, of course, is a big deal.

All right. Here's the piece I teased a few moments ago. It's about hair. You know, I remember the very day when I started to realize I was losing my hair. The year was 1975, the fall of 1975. I was sitting at my desk in the newsroom in Regina, Saskatchewan. I had recently been appointed the national reporter for Saskatchewan. So I was based in Regina, but I'd kind of split my week.

Half the time I was in Regina, half the time I was in Saskatoon. And a lot of time in between those two cities. And north of Saskatoon is up in Prince Albert more than a few times. But anyway, I was sitting at my desk, and another reporter was walking by and suddenly stopped, and she was clearly looking at the top of my head, and she went, Peter, you're losing your hair.

Oh man, I thought I was going to shrivel into a little tiny ball. I was, at the time I would have been 27, 28, somewhere in there. And I thought she was kidding. And then I started to realize, in fact, she's not kidding. She's serious. I'm losing my hair. And then you get to that, like I didn't do anything during the day, but when I got back

to my apartment, you go through that awkward process of trying to get a mirror to figure out how you can see the top of your head. And sure enough, she was right. And that began the process that I guess must have gone on for 10 years of trying to find the silver bullet that was going to stop hair from falling out and start hair regrowing. And, you know, for the millions, if not billions,

of men who've gone before me, there is no solution. There are just a lot of possible, you know, there are a lot of ideas out there that cost money that suck you in to paying for it to see whether or not

your hair is suddenly going to grow back and you're going to look like you know John Paul George or Ringo doesn't happen that way no matter what they tell you and no matter the letters I'm going to get as a result of saying this doesn't happen that way no matter what they tell you and no matter the letters I'm going to get as a result of saying this

doesn't happen anyway what's that got to do with today well turns out according to the New York Times that the pandemic is making your hair fall out if there weren't enough natural reasons for it to fall out the pandemic is apparently doing that

it's a quandary many this according to the times it's a quandary many people particularly women have agonized over in recent months as their brushes and shower drains are filled with tangles of hair. Google searches for hair loss increased by 8% in the last 12 months. According to the data science firm Spate, with the topic being searched an average of more than 829,000 times a month in the United States alone. That's how many people are typing into their Google search bar, you know, what's causing my hair loss?

Why am I losing hair? It's a frustrating boycott of both immense stress and post-viral inflammation from COVID-19. Known as telogen effluvium in the medical world, temporary hair loss results from fever, illness, and severe stress, pushing more hairs than normal into the shedding phase of the hair growth life cycle. Although hair loss tends to be associated with men because of the prevalence of male pattern baldness, telogen effluvium is more common among women who often experience it

after childbirth. So the difference between this and what I went through when I was 28, which was I was on the permanent decline. This is a temporary situation. Hair grows back when stress, et cetera, is relieved. But I'm sure when you're looking at a pile of hair at the bottom of the sink or in the bathtub, you probably have exactly the same feeling I had back in that day when that young woman pointed out that I was losing my hair. Anyway, what do you do about this? According to the New York Times, the first point of attack is an anti-inflammatory diet

that cuts out sugar, gluten, dairy, and alcohol, and incorporated colorful fruits and vegetables, oily fish, and healthy fats like avocados and nuts. Maybe kickstart a new supplement routine of Omega-3-6-9. Turmeric with fenugreek, evening primrose oil,

and two tablespoons of aloe juice a day. Combination she believes to be anti-inflammatory and lubricating for the skin and hair. And she also does daily scalp massages. This particular woman is having this problem. So actually, I'm going to write all those things down. And maybe I'll give it a go.

Who knows? Maybe all my hair will grow back. You never give up, right? You never give up. All right, quick glance ahead. Tomorrow, we're going to take a run at Bitcoin. Okay? The Bitcoin cryptocurrency craze i'm going to talk to somebody who has some thoughts on all of this former president of bmo tony copper he's written a book about his

experiences in the banking business but he's a pretty sharp guy. So we're going to listen to him on cryptocurrency for a few minutes. Wednesday, it's the second part of our two-part look at where things are heading in the energy business. Last week, it was this discussion about the slow decrease in oil production. And on Wednesday, we're going to talk about electric vehicles. Because I don't know about you, but you watch TV now, and you look at the ads for cars, and it seems every car manufacturer is talking electric.

They're coming out with their electric vehicle. We are on the verge of a big change. So we'll talk that on Wednesday on Smoke Mirrors and the Truth with Bruce Anderson and a special guest. Thursday, it's potpourri. Friday, it's the weekend special.

And I haven't decided on a topic for this week, so if you've got anything on your mind, you can write it in now to themansbridgepodcast at gmail.com, themansbridgepodcast at gmail.com, the Mansbridge Podcast at gmail.com. And as I've said, coming up in the near future, probably within about two weeks,

our feature interview with Caleb Dahlgren, the first survivor of the Humboldt Broncos bus crash, to write a book. And it's a remarkable book. And so is the interview. caleb dahlgren that's in a couple of weeks all right that's it for today the first day of march we're back in march so as much as you might think about what last March was like, think about what next March

is going to be like. It's going to be great. All right, I'm Peter Mansbridge. This has been The Bridge. Thanks for listening. Talk to you again in 24 hours.