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Confusion, health concerns and short supply mar Ontario's AstraZeneca vaccine pilot rollout – Toronto Star

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A provincial pilot project allowing people aged 60-64 in some Ontario cities to get a COVID-19 vaccination quickly became a source of frustration Thursday over unclear rules and limited supply, leading to questions for the government at Queen’s Park.

The confusion over eligibility and access came on the same day as the news that several countries were pausing their use of the same AstraZeneca vaccine because of concerns over blood clots.

The Ontario government’s website initially said only people “who were born between 1957 and 1961 (60 to 64 years old)” could sign up to be vaccinated in one of 327 pharmacies and some select clinics in Toronto, Kingston and Windsor.

By Thursday afternoon, the province had updated its website to read that vaccines should also go to people who “will be, or have been, 60 to 64 in 2021.”

Al Hood, who turns 60 in September, was born in 1961. It was tough convincing his local pharmacies he qualified for vaccine even after the update from the province confirmed his eligibility.

“We called multiple pharmacies to get him an appointment,” said daughter Laura on Thursday. “When we told them when his birthday is, they said he does not qualify as he has not yet turned 60. They refused him service and hung up on him multiple times.”

At Queen’s Park, Health Minister Christine Elliott came under fire for the confusion.

After a rash of complaints from people like Al, who had been turned away for shots, she said the government is “working with pharmacies” to clarify that anyone who turns 60 or 65 this year is cleared to get the AstraZeneca shot.

“If you’re 59 now but you will turn 60 in September … yes, you can still be given the shot,” she told reporters.

Opposition parties said the chaos was avoidable if the government would have been more precise in its eligibility criteria and said some vaccine-seekers may be out of luck for now after being rejected by busy pharmacies, which can be hard to reach with a deluge of callers.

“You actually have to try hard to screw up this badly,” said Liberal Leader Steven Del Duca.

Elliott’s office issued the following statement to reassure Ontarians: “You are eligible if you are 60-64 as of the day of vaccination OR, if you will be, or have been, 60-64 in 2021.”

Loblaw, the company that owns the pharmacy that refused Al Hood the vaccine, said in an email that there was initially “some uncertainty around the age specifications.”

The company went on to say, “We received clarification on eligibility criteria and have communicated that to all stores today.”

As of Thursday afternoon, the list of participating pharmacies emailed to the Star by Loblaw still said, in bold, “We will vaccinate only eligible individuals aged 60 to 64 years of age.”

Loblaw’s PR advised anyone erroneously denied appointments call their pharmacies back.

For Al, this was easier said than done.

“The pharmacies were picking up the phone and hanging right up,” Laura said. “We probably made 15 calls.”

By Thursday afternoon, the Hood family finally got an appointment for Al at a Loblaws in Greater Napanee, Ont.

In Toronto, long lines and dwindling vaccine stock made it difficult for some to get a dose.

Valerie Lopes, 62, said she spent a total of six hours and contacted around 30 pharmacies within 10 km of her East York home in the last two days trying to get the vaccine.

“It’s a nightmare,” she said. “Every time I tried to register, I was told there are no appointments left.”

Lopes eventually got put on a waitlist at a nearby pharmacy, but said the process doesn’t feel over yet.

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“I’m so nervous that it’s not going to happen,” she said.

Kathy Domoney, 61, had to call five Shoppers Drug Mart locations before she found one that still had the vaccine.

“I phoned to all the various Shoppers Drug Marts that the press release listed as available,” she said. “Several of them had recordings saying that they don’t have any vaccines. Seems like a lack of communication rolling it out.’”

Half an hour into her wait at the Coxwell and Danforth Shoppers, Marian Jen, 60, said she was glad things were moving faster Thursday — her neighbours had to wait in line for three hours the night before.

“Right now, we’re (vaccinating) about 40 patients an hour,” said John Papastergiou, a pharmacist at the Coxwell and Danforth Shoppers. “Unfortunately, we’re going to run out this afternoon, but there are three other stores on the Danforth getting vaccines today.”

Papastergiou said the other locations will be able to supply the neighbourhood with vaccines throughout the weekend.

“Hopefully after then we’ll have gotten some information on more supply,” he added.

According to the Ontario Pharmacists Association, The project is still ramping up, and will launch more broadly on Friday after more vaccines arrive.

The Canadian Press reported Thursday at least nine European countries were pausing their use of AstraZeneca’s doses — some entirely, and others only on specific batches — pending further investigation of the clots.

But the provincial health minister said that Ontario would proceed with the rollout of the vaccine.

“AstraZeneca has been approved by Health Canada,” Elliott said, saying the province will follow any evolving science and data on the issue. “I don’t think this is going to deter anyone.”

New Democrat Leader Andrea Horwath said she would have preferred to hear specific details from the minister or her officials on the latest guidance from Health Canada, which approved AstraZeneca two weeks ago, on the European concerns.

“I think that would have provided more of a comfort level or a confidence level.”

The Star was contacted by several Toronto residents who cancelled vaccination appointments in the coming days because they had left their names on waiting lists at several pharmacies, and were asked if they were backing out because of the blood clot issue.

The European Medicines Agency is probing the issue but says 30 blood clots in more than five million patients who received the vaccine is not out of step with the normal rate of blood clots in the general population.

With files from Maria Sarrouh and Angelyn Francis

Ben Cohen is a Toronto-based staff reporter for the Star. Follow him on Twitter: @bcohenn

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Ontario hospitals may have to withhold care as COVID-19 fills ICUs

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By Allison Martell and Anna Mehler Paperny

TORONTO (Reuters) – Doctors in the Canadian province of Ontario may soon have to decide who can and cannot receive treatment in intensive care as the number of coronavirus infections sets records and patients are packed into hospitals still stretched from a December wave.

Canada‘s most populous province is canceling elective surgeries, admitting adults to a major children’s hospital and preparing field hospitals after the number of COVID-19 patients in ICUs jumped 31% to 612 in the week leading up to Sunday, according to data from the Ontario Hospital Association.

The sharp increase in Ontario hospital admissions is also straining supplies of tocilizumab, a drug often given to people seriously ill with COVID-19.

Hospital care is publicly funded in Canada, generally free at the point of care for residents. But new hospital beds have not kept pace with population growth, and shortages of staff and space often emerge during bad flu seasons.

Ontario’s hospitals fared relatively well during the first wave of the pandemic last year, in part because the province quickly canceled elective surgeries.

The College of Physicians and Surgeons of Ontario told doctors last Thursday that the province was considering “enacting the critical care triage protocol,” something that was not done during earlier waves of the virus. Triage protocols help doctors decide who to treat in a crisis.

“Everybody’s under extreme stress,” said Eddy Fan, an ICU doctor at Toronto’s University Health Network. He said no doctor wants to contemplate a triage protocol but there are only so many staff.

“There’s going to be a breaking point, a point at which we can’t fill those gaps any longer.”

In a statement, the health ministry said Ontario has not activated the protocol. A September draft suggested doctors could withhold life-sustaining care from patients with a less than 20% chance of surviving 12 months. A final version has not been made public.

Ontario’s Science Advisory Table had been forecasting the surge for months, said member and critical care physician Laveena Munshi. During a recent shift she wanted to call the son of a patient only to discover he was in an ICU across the street.

“The horror stories that we’re seeing in the hospital are like ones out of apocalyptic movies,” she said. “They’re not supposed to be the reality we’re seeing one year into a pandemic.”

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In COVID-19 vaccination pivot, Canada targets frontline workers

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By Anna Mehler Paperny

TORONTO (Reuters) – Canada is shifting its vaccination campaign to target frontline workers, moving away from a largely age-based rollout as the country tries to get a handle on the raging third wave of the pandemic.

Canada‘s approach thus far has left unvaccinated many so-called “essential workers,” like daycare providers, bus drivers and meatpackers, all of whom are among those at higher risk of COVID-19 transmission. Provinces are now trying to adjust their strategy to tackle the surge driven by new variants.

Targeting frontline workers and addressing occupation risk is vital if Canada wants to get its third wave under control, says Simon Fraser University mathematician and epidemiologist Caroline Colijn, who has modelled Canadian immunization strategies and found “the sooner you put essential workers [in the vaccine rollout plan], the better.”

Initially, Canada prioritized long-term care residents and staff for the vaccines, as well as the very elderly, health workers, residents of remote communities and Indigenous people.

Targeting vaccinations by age made sense early on in a pandemic that ravaged Canada‘s long-term care homes, Colijn said. But now, immunizing those at highest risk of transmission brings the greatest benefit.

“If you protect these individuals you also protect someone in their 60s whose only risk is when they go to the store. … The variants are here now. So if we pivot now, but it takes us two months to do it, then we will lose that race.”

Data released on Tuesday from the Institute of Clinical and Evaluative Sciences showed that Toronto’s neighbourhoods with the highest rates of COVID-19 infections had the lowest vaccination rates, underscoring the disparities in vaccination.

‘IT’S A JUGGERNAUT’

On Wednesday, Ontario Premier Doug Ford announced a plan to have mobile vaccine clinics target COVID-19 “hotspots” and high-risk worksites, although he stopped short of giving people paid time off to get the shot.

Karim Kurji, medical officer of health in York Region north of Toronto, characterizes the shift in vaccination priority from age to transmission risk as moving from defence to offence.

“It’s a juggernaut in terms of the immunization machinery, and turning it around takes a lot of effort,” Kurji said.

Meanwhile, officials in the western province of Alberta say they are offering vaccines to more than 2,000 workers at Cargill’s meatpacking plant in High River, site of one of Canada‘s largest workplace COVID-19 outbreaks. Provincial officials said in a statement they are looking to expand the pilot to other plants.

Quebec will start vaccinating essential workers such as those in education, childcare and public safety in Montreal, where neighbourhoods with the highest vaccination rates have been among those with the lowest recorded infection rates.

The people doing the highest-risk jobs, from an infectious disease perspective, are more likely to be poor, non-white and new Canadians, health experts say. They are less likely to have paid leave to get tested or vaccinated or stay home when sick and are more likely to live in crowded or multi-unit housing. They need to be prioritized for vaccination and their vaccination barriers addressed, experts say.

Naheed Dosani, a Toronto palliative care physician and health justice activist, said making vaccines available to high-risk communities is not enough without addressing barriers to access.

“The face of COVID-19 and who was being impacted changed dramatically. The variants seemed to take hold in communities where essential workers live. … This [pivot] is a step in the right direction and will hopefully save lives.”

 

(Reporting by Anna Mehler Paperny; Editing by Denny Thomas and Aurora Ellis)

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Canada finance minister: Pandemic an opportunity to bring in national childcare

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OTTAWA (Reuters) – The COVID-19 pandemic and its damaging impact on women has underlined the need for a national childcare plan, which would also help the economic recovery, Finance Minister Chrystia Freeland said on Thursday.

Since taking up her job in August, Freeland has repeatedly spoken about a “feminist agenda,” and has said childcare will be part of a stimulus package worth up to C$100 billion ($79.6 billion) over three years. She will unveil details in her April 19 budget.

“I really believe COVID-19 has created a window of political opportunity and maybe an epiphany … on the importance of early learning and childcare,” Freeland told a online convention of Canada‘s ruling Liberal Party.

The budget is set to be a springboard for an election that Liberal insiders say is likely in the second half of the year.

Canadian governments of various stripes have mused about a national childcare program for decades but never acted, thanks in part to the cost and also the need to negotiate with the 10 provinces, which deliver many social programs.

Freeland said a childcare program would help counter “an incredibly dangerous drop” in female employment since the start of the pandemic.

“It is a surefire way to drive jobs and economic growth … you have higher participation of women in the labor force,” Freeland said. “My hope … is that being able to make that economic argument as well is going be to one of the ways that we get this done.”

Freeland, who is taking part this week in meetings of the Group of Seven leading industrialized nations and the International Monetary Fund, said U.S. Vice President Kamala Harris and Treasury Secretary Janet Yellen had told her they saw early learning and child care as a driver for economic recovery.

($1=1.2560 Canadian dollars)

 

(Reporting by David Ljunggren; Editing by Leslie Adler)

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