The Bridge with Peter Mansbridge - Will We Need A Fourth Vaccine Soon?

Episode Date: February 22, 2022

It's our regular weekly (day later than usual because of yesterday's holiday) check-in on Covid.  But first some thoughts on the Ukraine story, and the trucker's story and the importance of words.  Epidemiologist Dr. Zain Chagla joins us with his take on yet another vaccine shot, and also how concerned we should be about the variant BA2

And hello there, Peter Mansbridge here. You are just moments away from the latest episode of The Bridge. Are you ready for a fourth shot? A fourth vaccine? You might start thinking about it. And hello there. Welcome to Tuesday. Welcome to the first day of the week when you don't count the holiday that was yesterday. Hope you had a great weekend. Here's the initial message for today. Words matter. We've said this before. Lots of people have said it before. We didn't originate it here at the bridge, but words matter. We've said this before. Lots of people have said it before. We didn't originate it here at the bridge, but words matter.

We watched that a lot over these last couple of weeks, covering the story in Ottawa. You know, was it a protest? Was it a siege? Was it an occupation? Was it an insurrection? Well, different people placed different values on those words during the coverage of that story, and they still do today. Why am I talking about that? Well, I'm watching how words matter in the most dominant story globally right now, as of this day, which is the situation in Ukraine.

Vladimir Putin, after weeks, months of bluster, made his move yesterday. He ordered his forces into a certain area of Ukraine on the eastern edge, the Donbass region, where there are a couple of rebel-held areas. Russian rebels have held a couple of areas there, and he ordered his troops in to that section of Ukraine. So the words that matter are invasion, or it's not an invasion. Sounds like an invasion to some people.

To others, it doesn't. And why doesn't it? Well, Russian forces have actually been in those regions for the last seven or eight years. They went in at the same time that Russian forces went into Crimea. And, you know, at the time, people made a bit of a fuss about it, but not much in terms of the West, right?

They didn't do anything like they've been threatening to do this time around. Here's one of the ironies about that situation eight years ago. It came immediately after the end of the Olympics in Sochi. Sounds like a strategic similarity. Ended the Olympics yesterday in Beijing. And boom, Putin moves. Same day, within hours of the end of the Olympics, just like he did eight years ago.

So now, after much bluster from the U.S.-NATO side, they're trying to come to grips with whether or not this is an invasion. Is it technically invasion if there were already Russian troops there? And if they do decide it was an invasion, do they then kick in with all the retaliatory measures that they had planned to do, that they didn't do on Crimea? They did some, but it seemed to have little of any effect. They're threatening much bigger retaliatory measures right now.

And a hint from the Germans that one of those measures may be the end of the pipeline from Russia into Germany, which has been something that many of the Western countries have wanted Germany to do. And it seems like they are now willing to do that, which would be a big hit economically to the Russians. And it would leave open Germany as to, well, okay, what are you going to do for your energy supply? Because they cancelled their nuclear program and we're going to replace it with this pipeline from Russia. Well, now other Western countries are scrambling, mainly the US, as to how would we get energy to

Germany? And they promised they would do that if the Germans cancelled that pipeline. So things are happening and my only point at this point because they're literally changing by the hour, my only point at this point is that words matter. And so you listen very carefully at some point. You know the Americans will talk today and they'll listen carefully to the words that are used.

So that story is huge. And it will dominate international news for the next few days at least. Now this happens after a weekend of major news in Canada, certainly in Ottawa, as the end of the protest, siege, occupation, insurrection, took place. And the streets now are clear.

The Prime Minister says there's still a threat and therefore the Emergencies Act which was put into place to help them clear the streets and go after the people involved stays in effect. At least for the next little while.

It has to run out within 30 days, but it may be much sooner than that. But the Prime Minister is suggesting that many of the truckers and vehicles involved haven't gone far. They're kind of staged outside of Ottawa right now, and he fears they may try to come back, and security forces are monitoring that situation. But that story, which was dominant for three weeks,

and certainly over the weekend, with every moment carried by the networks live, Twitter had a field day. But that's gone, bing! It's disappeared, it seems, in the moment. Replaced by the Ukraine story. But, you know, through it all, there's another story that sort of hangs over the country, hangs over the world, and hasn't gone away.

And as you know, the first episode of The Bridge each week for the last couple of years has been about the pandemic, has been about COVID. Now, yesterday, Monday, was a holiday, and therefore it was an encore presentation of one of our shows from last week. So today's the first up-to-date episode of The Bridge for this week, and therefore we're also going to use this day to talk a little bit about where we are in the pandemic, as we've been known to do on the first day of each week. And we've always had as our guide one of our epidemiologists from different parts of the country.

And today it's Dr. Zane Chagla is up from Hamilton. And we're going to check in with him. This, you know, one of the stories that kind of got buried. It of got buried. It did get buried. There was very little talk about it last week. Was the fact we passed the 36,000 mark in terms of deaths in Canada. As a result of COVID.

Having said that, numbers are dropping. Hospitalizations are dropping across the country. So we keep that in mind as we're talking to Dr. Chagla, who is in a couple of places, McMaster University in Hamilton, also the St. Joseph's Healthcare in Hamilton. And he's a well-known infectious diseases epidemiologist involved in a lot of advisory groups,

both provincially and I think federally as well. So we've got Dr. Jagla's sense of where we are on this right now in the next couple of moments as he joins us. And also I want to just give you this. Later on the bridge today, I've got a special little feature that you might enjoy on the most famous door in the world. And some what we call fun facts about that door.

So first of all, you've got to guess what is the most famous door in the world? That's my sense. It's the most famous door. May not be yours, but take a run at trying to guess what it is. All right. We're going to have our up-to-date chat on where things stand on COVID with Dr. Zane Chagla, and we'll do that right after this. And welcome back. Peter Mansbridge here in Stratford, Ontario.

You're listening to The Bridge, this Tuesday episode on Channel 167, Sirius XM Canada, Canada Talks, or on your favorite podcast platform. Wherever you're joining from, we're happy to have you with us. All right, as promised, Dr. Zane Chagla joins us now for his sense of where we are on the COVID story.

So let's get right at it. Here's our conversation so let me start uh it kind of where we started the last time around because it was about three weeks ago three or four weeks ago that we last talked and we're starting to be the rumblings of you know it's time to get back to some sense of normal uh and the provinces and ottawa to a degree we're talking about heading in the in that direction well there's been a lot of heading in that direction since not everybody's the same in terms of how many restrictions have been dropped but they're all heading in that direction without any doubt how comfortable are you with that yeah look you know i i think there is something

here to say about getting back to normal and advertising that right you know i i think there is something here to say about getting back to normal and advertising that right you know i i think we do have to have long-term plans with many of these measures where there's off switches for them and and people need to know they're in the future as i think you know we've been in a state of two years where we were told to get vaccinated where people's risks are fundamentally different than they were in March of 2020, where the vast majority of the population, you know, will do fine when they get Omicron. And in fact, you know, 30 to 40% of our population likely has gotten Omicron over the last two months. You know, there's there's something there to say, okay, do we have to

shut down businesses? Do we have to, you know, keep these vaccine mandates in place? Or, you know, there's something there to say, okay, do we have to shut down businesses? Do we have to, you know, keep these vaccine mandates in place? Or, you know, do we have the tools right now to make sure that people have good outcomes for the most part from their infection? And recognizing that there's much more immunity in the population that likely also adds another layer of protection. You know, that all of these are the formula to get back to normal as many other countries are starting to engage with recognizing that unfortunately COVID is going to be here forever and you know the pathway has to be people have to get back to normal at some point. You know when you suggest that 30 to 40 percent of the population has probably already had Omicron

are we saying in that that there are probably people who've had it who don't even realize they've had it yeah absolutely look you know a lot of people there were some that were asymptomatic uh you know there's not much testing going about in the community so we know there's a lot of people that just kind of had a couple of days of symptoms stayed home figured they had it maybe one person had a rapid test and there were 10 of them behind that person that actually probably were infected. And, you know, at least in Ontario, again, the wastewater analysis and kind of testing of health care workers looks like, again, their estimates were somewhere between 1.5 and 4 million. And in fact, you know, that that's what they base their hospitalization

estimates on. And we're coming well under those hospitalization estimates suggesting it's actually probably more people infected than that 4 million. So that's a lot. And, and again, you know, this, there's credible estimates from from global organizations suggesting 50% of the population will see it by the end of March. And really, you know again it gets to that point of well there's even more immunity in the population now the chances of someone having severe diseases they've gotten through their omicron infection had a full series of vaccines is probably going down by the day uh and again you know that there has to be a point where we have to think society is safe enough to open up, recognizing that this is going to be a pathogen. It's going to be around forever.

We're going to be exposed, you know, multiple times. Let me read you a quote from Boris Johnson yesterday. As England really, you know, dropped all their restrictions, they basically said, okay, we're, you know, we're moving on. Everything's changing. Everything's being dropped. But here's what he said. It's just part of what he said. We have a very clear view of this.

This, and when he says this, he's talking about COVID, has not gone away. We're able to make these changes now because of the vaccines and the high level of immunity and all the other considerations about Omicron that you've seen. But we have to face the fact that there could be, likely will be, another variant that will cause us trouble. Now, you could say he's trying to have it both ways there. But he's also suggesting, well, he's not suggesting, he's saying, this is not over. And we could get hit hard again with another variant. Yeah, absolutely.

Is that the right approach to take? the virus is evolving but again i don't see you know ongoing restrictions mandates etc being the solution for another variant right we have let this virus spread to every corner of the earth we have not done our due diligence about vaccine equity and so you know we are going to see variants in places in the world where all they've had is natural immunity over and over and over again as their own can only control and you know we can't shield ourselves from the rest of the world we have to allow travel we have diverse families you know our country is not an island we have to you know coordinate with other places it is going to come over the border as this virus evolves with it again what has gotten us through

prior pandemics what has gotten us through prior pandemics, what has gotten us through infections over time, other respiratory tract infections, is the development of immunity and therapies to it. And we are in a very different place. If you went out on the street and you tested everyone's antibodies in a place in Ontario or in BC, you'd probably find 95% of people with antibodies. Most of them were from vaccinations, but most of them were from vaccinations but some of them were from being infected over the last two years you know that's going to give another layer of control here for things going forward maybe you're going to get breakthrough infections in the future but the bar to cross to make people severe enough to pass through all that immunity to land in hospital at the end of it is going to be much different than it was in 2020 when we're a completely naive population you know there is much more immunity that is going to keep people out of health care and you know that's going to be an asset for us

going forward with this do you worry about this variant um ba2 you know i i uh i had this sense that until they give it a greek letter it can't be that serious yeah we knew it was here actually right at the beginning of omicron right it was funny because we knew about this because it kept screwing up our lab tests for omicron because it you know was was it the one gene that we look for for omicron uh gets turned off by this one and again it it was a lab issue more than anything else. And then we started realizing elsewhere in the world, it started becoming the dominant variant in that sense. There is some lab studies suggesting

maybe it is a bit more dangerous to lung tissue. But at the same time, we see in places in the real world where it's been circulating broadly that they haven't seen a resurgence of the pandemic. South Africa, which gives us a window into what happened with Omicron, you know, is all BA.2 right now. And they're seeing hospitalizations at a low. They released a preprint yesterday suggesting that the hospitalization rate with BA.1 or BA.2, the Omicron or this new BA.2 variant is exactly the same. And there's at least data suggesting people who are infected with BA1 or have completed three series of vaccines still have the same efficacy of protection in the future.

So maybe we'll see a bit of a shoulder here. Maybe we'll see decline being a little bit slower as BA2 rises. It's probably a very dangerous time to be someone unvaccinated and never had COVID before because of the fact that this variant may not be as forgiving as BA1. But at the same time, you know, real life is showing us it's not causing wide scale disruption, even in places that are seeing only BA2 as their variant. back to Boris Johnson again for a second because the other thing he's told the people of the UK this week is that a fourth vaccine another booster starting for people over 75 almost immediately in the next few weeks or month he wants that started and it'll probably be a booster for everybody by certainly by the late summer early fall is that the direction we're heading here as well you know there are some merits for fourth doses in certain populations and people who are

immunocompromised absolutely and we've been doing that there's recommendations coming from many organizations suggesting that you know we in ont, we'd be giving birth doses of people in long term care because we know they're at the highest risk of dying. And we're trying to do everything in our power to keep that under control in the most part. it is predominantly people of older age over 70 and 80 who really faced even with vaccines you know that that remarkably saved their lives and certainly the unvaccinated people suffered the most you know of the people that were vaccinated that suffered it was the older people in that age group um so there is something to be said there about people in that age group really getting focused therapies to boost their immune system as high as possible to get them through the most severe complications of this disease. But going to younger populations

is a whole lot different here, right? Does an 18-year-old really need four doses of a vaccine, especially if they got Omicron in the last two months and their immune system is basically as well designed as it can be to deal with this virus. And so, you know, as we start going into these vaccine approaches going to the future, I think we're probably going to customize them a little bit more to say what populations are going to benefit the most. Rather than these blanket statements to say everyone needs to get it, recognizing that, you know, we haven't even gotten people back for their third doses that probably do need their third doses. And every integral step on top of that is going to add more complexity and is going to have some more drop off over time. Any change to the sense that there's going to be a need for an annual just on COVID? Yeah, absolutely. The virus is evolving and, you know, that might mean that we do need annual immunizations. But, you know, again, we don't know what vaccines are going to look like

in a year, right? There's some promising work being done on a new set of vaccines where there's much more stability in this and that they treat more coronaviruses than just SARS-CoV-2. There's work being done on intranasal and inhaled vaccines where, you know, again, may block transmission because that's where the virus first lands and their immune system first access. So, you know, I think, again, it's hard to draw out this future. We may see a completely different generation of vaccines that really does help with, you know, achieving herd immunity or more disease control. But, you know, the virus is variable and there probably is a need right now with the tools we have to make sure

that the most vulnerable people have, you know, the most optimal immunity, especially going into the wintertime when we know it's going to spread more. If you can get in the helicopter for a minute and look down at this after two years, where are we? Much better.

Look, we have vaccines. We vaccinated 90% of the adult population in Canada. We have treatments that we are rolling out by the day and we're going to get more access to them. We have large scale testing. We have, you know, a wealth of experience in dealing with this in healthcare. You know,

our biggest handicaps are still healthcare capacity across the country, which is a problem that pre-existed COVID, but it's certainly been exacerbated. But, you know, there's a lot more hope here. That future looks bright. That again, you know, as we go day by day, the deadliness of this virus comes down and down. There's UK data suggesting, you know, it's under two times the flu mortality, which is, you know, from 20 times the flu mortality

at the beginning of the pandemic, you know, we're whittling things down. And it's been incredible seeing what's happened in the last few years of progress. The next year is probably going to bring a whole lot more tools to the forefront that really whittles down the mortality more and more. So what's your, what's your advice to the ordinary Canadian at this moment in time, watching what's going on around us, watching what's going on in the big picture in terms of the global situation, but in the national situation and the provincial situation where things, restrictions winding down, what's your advice to the ordinary Canadian about how they should act, how they should behave, how they should play out their daily life now?

Look, everyone needs to do a risk assessment based on their health conditions, based on their age, of what they want to engage with with society as things move forward. As things get better, there's going to be more tools. And so maybe the time to do those higher risk things for a 70 and 80 year old

may not be the time right now keep the gathering small keep wearing a mask appropriately you know avoid those very high contact settings and and you know make sure you're cognizant of people coming into your lives but if you're an 18 year old who's fully healthy who's gotten their full series of vaccines the risk of a serious outcome, the risk of dying here in this age group is essentially less than being struck by lightning. And so I think this is it. The gradient has certainly kind of changed and people's risks need to be taken into account for that.

And yeah, I think that's really the path moving forward. If things open up, it doesn't mean everyone needs to do everything that's out there. But there are certainly people that are much more protected now than they will ever be. And the world is as safe as it's ever going to be for them. And there are people that are so vulnerable and they need to know that, you know, again, because we can actually likely, even in a breakthrough infection, start treating them and reduce the risk of hospitalization or death. And they may want to wait it out. And as more tools come to market, there's going to be more ability

for those people to have an extra layer of security going forward. I bet they'll be loading all those new treatments into the queen right now. Yeah. I would presume that a 95 year old meets every expectation for treatment. So, you know, I, I, I would not be surprised that she's received some of the drugs we give today for sure. Well, she seems pretty, you know, they say she's,

she's still working on a light schedule and all that. But as you say, she's 95. And I mean, that's a vulnerable age for anything, let alone this. Dr. Chagla, thanks so much for your time. No problem. All the best. Dr. Zane Chagla from McMaster University in Hamilton, Ontario, and his take on things. You know, one of the phrases that we've heard a lot, and while he didn't use it exactly in that conversation,

you knew he was heading in that direction, is this phrase that a lot of epidemiologists, a lot of officials, a lot of politicians use. The pandemic doesn't end anywhere until it ends everywhere. Basically, they're saying, hey, it's great. Canadian numbers are really good, but you know what? It doesn't matter until you make sure those numbers are good everywhere. And parts of the world where vaccines are still not getting to,

they've got to get them or it's all going to bounce back. And variants get started in other parts of the world, and because of the kind of world we live in now, it won't take long before it gets here. We saw that with Omicron. Anyway, Bloomberg has an article that came out the other day, which gives us a sense of where we are on that front, because the countries that couldn't afford vaccines,

couldn't access vaccines, were depending on the rich nations of the world to help them on that front. So Bloomberg's report says that for the richest nations, the money needed to supply lower income countries with the tools needed to end the pandemic would be little more than a budget rounding error, according to the head of the World Health Organization. Yet there are few signs the wealthy are willing to pay their fair share to help deliver COVID-19 vaccines,

medical equipment, and treatments to low-income countries. Just six nations, Canada, Germany, Kuwait, Norway, Saudi Arabia, and Sweden, Canada, Germany, Kuwait, Norway, Saudi Arabia, and Sweden, just six nations met or exceeded their fair share commitments to the WHO's 2021 accelerator program budget, which includes the COVAX vaccination effort that delivered more than 1 billion doses to low and middle-income countries. The United States was by far the biggest donor to the program, but still it failed to provide all the funds it was asked for, giving 64% of what it had been asked for.

China was asked for the second most, but gave just 3% of its ask. Russia, it didn't give a thing. Nothing. With rich countries in Europe and north america moving to loosen and even abandon covid restrictions altogether this year's funding gap might be worse of the 16.8 billion dollars needed from wealthy countries for the budget only about800 million has been raised so far. That's after a couple of months, almost two months of the year. So those aren't encouraging numbers, and they don't help us head towards that, fulfilling that phrase, the pandemic doesn't end anywhere until it ends everywhere.

All right. I promised something a little more fun than truckers and Ukraine and COVID to end the bridge today. And here it is. The most famous door in the world? Well, this is to me the most famous door in the world? Well, this is, to me, the most famous door in the world. Maybe you had a different one. But maybe some of you guessed which door that was. And if you guessed 10 Downing Street in London,

the home of the British Prime Minister, then you guessed right. Well, this story was in the telegraph over the weekend and it's called The Secrets of the Number 10 Front Door so the next time you see it and you always see it right when you

stories on Boris Johnson or whoever the British Prime Minister has been. They always seem to center on number 10 Downing Street. You see them walking in and out of that door. So here are a few things you may not have known. The original six-panel Georgian door made of black oak was installed in 1772, and it was there for more than 200 years.

It was installed when Lord North was prime minister. Remember him? Well, good for you, because I don't. It was part of an extensive renovation that saw three Downing Street properties knocked into one of suitable grandeur for the prime minister.

But in 1991, they replaced the old six-panel Georgian door made of black oak with a black gloss-finished steel door installed for, you guessed it, added security. After an IRA attack when John Major was Prime Minister, it saw a mortar land in number 10's back garden. When it needs maintenance and it's taken off,

it has an equally robust twin that holds the fort. So if you've looked really closely at the door on number 10 Downing Street, you've probably noticed that it doesn't have a keyhole. If you can see past the press pack, regularly gathered outside, says the telegraph, the eagle-eyed will notice that there's no lock in which to put a key and no handle. This is a door that can only be opened from the inside, where the brass doorbell to its right is for decorative purposes only. A security guard is on duty 24-7 watching security cameras so it can swing open as if by magic on cue to allow in prime ministers, ministers, monarchs, and assorted visiting dignitaries. There was one time the door didn't open on cue,

and the U.S. Secretary of State, John Kerry, was arriving for his first ever visit to the prime ministers. It was Theresa May who was the PM at the time. And he walked straight into the door because he thought it was automatically going to open, which it didn't. It wasn't always black. Here's one of those fun facts. There's something solid, serious, and stately

about today's glossy black door. But back in 1908, Herbert Asquith decreed at the instigation, it is said, of his wife, that black was passe. Instead, it was given a lick of what historical paint consultants have suggested was either Brunswick green or bronze green. I like to call it like British racing green. That's the color I've always thought was the best way to describe that color.

As popular then with those in the know as gold wallpaper is today. The experiment didn't last though. Asquith's successor, David Lord George, known for his colorful turn of phrase and private life, proved to be more sober and traditional when it came to picking paint. You seen a letterbox there in the door?

You know, the kind that flips up and you put the mail through? If you've ever wondered why those delivering petitions to the Prime Minister can't just slip their bundle of papers through the shiny brass letterbox, there's an easy answer. Despite appearances, it is not a letterbox at all, but a shiny brass plate simply made to look like one for security purposes. And it's inscribed with the words, First Lord of the Treasury. That's because when Sir Robert Walpole took on the House in 1735,

that was his official title, though he was de facto Prime Minister. All his successors since 1905 have held both offices simultaneously. And here's the last little secret of the door at 10 Downing Street. The original lion's head door furniture, the knocker, was made of cast iron, the essential ingredient of the Industrial Revolution that began in Britain. At the outset of the First World War, soldiers about to depart for the trenches are reported to have walked up Downing Street to touch the knocker for good luck.

During the 1960 renovations, it was replaced by a brass lion's head painted black. And with Downing Street now out of bounds to the casual passerby, it's in no immediate danger of being rubbed off. It's interesting, you know, in that last space since the early 90s, you used to be able to drive by the White House on Pennsylvania Avenue in Washington.

You know, it was just another street. Can't do that anymore. It's all closed off. Just pedestrian traffic. Downing Street's even tougher. Can't drive along Downing Street's even tougher. Can't drive along Downing Street and unless you've got the proper passes you can't walk along Downing Street either. Will that happen in Ottawa? Some people have been wondering after what we've witnessed these last few weeks whether Wellington Street in front

of the Parliament buildings and the Prime Minister's office should be closed off and just pedestrian traffic. We'll see if that happens. It certainly happened in other parts of the world. Just looking at the original door. That original door that was placed in the 1700s is still available to see. And it's in the old Churchill war rooms. I've been there.

If you've never been there on your visits to London, if you get a chance to go, you should. It's really a slice of history to go through the old war rooms. That's where he used to have his war cabinet. But the door is in there. The old door. So look, don't you know all kinds of things

now you didn't know before this? Today's podcast. Broadcast. Podcast. Broadcast. Broadcast on SiriusXM, podcast on your favorite podcast platform. I'm Peter Mansbridge.

This has been The Bridge for Tuesday of this week. Tomorrow, Bruce Anderson will be here with Smoke Mirrors and the Truth. Thursday is a chance for your letters. The Mansbridge Podcast at gmail.com. I picked some of the best. And Friday, of course, another fabulous little edition of Good Talk with Chantelle Hebert

and Bruce Anderson. That's it for this day. I'm Peter Mansbridge. Thanks so much for listening. We'll talk to you again in 24 hours.