As the precise order of who will follow seniors, health care workers and high-risk populations in line to get COVID-19 vaccines is still being sorted out, Prime Minister Justin Trudeau says the federal and provincial governments agree that there should be a cross-Canada “consensus” on the matter.
With Health Canada now beginning its assessment of a fourth potential vaccine candidate — Johnson & Johnson’s — the prime minister said talks are ongoing with the provinces and territories about the “challenging ethical and societal” aspect of the country’s vaccine rollout.
Logistics aside, governments and health care experts are having to weigh and decide who will be prioritized and what the eventual order of precedence will be for Canadians to line up and be vaccinated.
According to the preliminary guidance issued by the National Advisory Committee on Immunization, prioritization will be based on three factors: the state of the pandemic when the vaccine is available; the supply available and number of doses required; and the risk-benefit analysis of key populations such as those who are at higher risk for adverse outcomes if they contract the novel coronavirus.
Based on that advisory group’s preliminary guidance, the recommendation is that essential workers and others who face increased risks related to COVID-19 should be vaccinated against the disease before everyone else. Examples of those at higher risk include providers of essential services, or those whose living or working conditions put them at higher risk.
The subsequent order of who gets vaccinated next remains a largely open question, however, in the race to see 70 per cent of Canadians vaccinated by September.
“We talked about it with the provinces last week on our 22nd first minister’s call, and there was a number of perspectives, but there seemed to be a consensus that we should all agree across the country on what that list looks like and make sure that it is applied fairly right across the country,” Trudeau told reporters on Tuesday.
“There are more conversations to come and we will keep Canadians informed as we determine what that right order of priority is. Other elements of it is, certain vaccines might be more effective with certain populations versus others, and that’s why the experts are going to be so important in making determinations around, what is the best path to move forward for our country,” said the prime minister.
Though, Health Minister Patty Hajdu said later that provinces will be able to refine the prioritizations based on their own regional demographics.
“At the end of the day it is the provinces who deliver health care and it is the provinces who will decide on the priority populations and of course we’re working closely to make sure that we have coordination across the country, and that we agree on the principles, which in fact we have, we have a shared set of principles,” Hajdu said.
“There are also some federal populations that we will obviously have to take care of ourselves as the federal government,” Hajdu said. Examples of these groups would presumably be Indigenous communities and federal inmates.
Manitoba Premier Brian Pallister said on Tuesday that he and other premiers still have outstanding questions that need to be answered.
“Clearly we need our most vulnerable folks, our seniors… our front-line care workers to get the vaccine earlier, we can all agree on that. But the devil’s in the details, when you get beyond that. Should it be done on the basis of age? Or how do you determine vulnerability? Should it be done on the basis of ethnicity? Should it be done on the basis of race in some way? These questions have to be addressed,” Pallister said.
“We’re not saying the federal government has to do it all but we’re saying that we need to have the criteria established and the priority should be common, not different in one side of Saskatchewan’s border with Alberta than it is on the other, or not different than it is in Ottawa from Gatineau, but rather that we have a co-ordinated strategy.”
In an interview on CTV’s Power Play, New Brunswick Premier Blaine Higgs said in his province he doesn’t anticipate there will be a huge line up of people who want to get vaccinated early on, but communicating as clearly as possible in advance of who will be eligible first will help avoid a “panic situation.”
So far, just over $284 million has been spent on distributing vaccines to Canadians, with overall more than $1 billion allocated to Canada’s vaccine procurement effort, as part of a more than $14-billion commitment over the next several years on research into and development of vaccines and therapeutics.
AGE MAY BE KEY FACTOR: TAM
Chief Public Health Officer Dr. Theresa Tam said Tuesday that work is underway right now on getting more “granular” in planning who among the highest risk groups will be first.
“That detail work is, you know, being taken very seriously by the provinces and territories as they begin to plan their immunization clinics.”
Then, once the priority groups are immunized, it’s possible the next easiest way to break down the order would be by age, said Tam.
“The age group, based on our analysis is actually the easiest and the most scientifically-sound way, I think, of increasing the population coverage,” she said.
“We know that underlying medical conditions put people at high risk but when we actually analyze all the different underlying medical conditions, and their age, it still comes out that the age is in fact the most important where you look at severe illness and mortality.”
There will also be groups who won’t be able to get a vaccine early on, due to the lack of research into the potential impacts on them, such as children and people who are pregnant.
“Kids haven’t really been engaged in a lot of the clinical trials, so that would be another age group for which data is needed, and we’ll be looking towards more data on pregnant women as well,” Dr. Tam said.
Asked whether he anticipates being among the earliest groups to get vaccinated, Trudeau said that he’s “going to trust the experts to make the right determination of what the priority populations are.”
With files from CTV News’ Ryan Flanagan
How the spread of coronavirus variants could completely change the pandemic in Canada – CBC.ca
This is an excerpt from Second Opinion, a weekly roundup of health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.
More contagious strains of the coronavirus have rapidly spread to more than 50 countries around the world, raising concerns that they may already be silently driving spikes in cases in Canada that threaten to overwhelm the healthcare system.
Variants recently identified in the United Kingdom, South Africa and Brazil are transmitting much more easily than the original strain, with the first estimated to be at least 56 per cent more transmissible.
But while early research shows the variants don’t necessarily lead to an increase in severe illness, health experts are growing more concerned about the effect the more transmissible variants could have on our already strained hospitals.
“We’re already at a breaking point,” said Dr. Susy Hota, an infectious disease specialist at the University Health Network and an associate professor of medicine at the University of Toronto.
“It’s happening at a time when the system’s already stressed to the point of potentially being overwhelmed.”
Dr. Eric Topol, a U.S. physician, scientist and clinical trials expert who heads the Scripps Research Translational Institute in California, said he’s “deeply concerned” about the spread of the new variants globally.
“If a strain is more infectious, substantially more, that means more deaths, more hospitalizations, more ‘long COVID,'” he told CBC News.
“We keep hearing it doesn’t cause worse illness. Well, it doesn’t have to — it just causes more people to have that same illness.”
Topol said the variant first found in the U.K., also known as B117, exhibits changes in the spike protein — a key component of how the coronavirus binds to human cells. He said that those changes are likely behind its higher transmission, with the altered spike protein potentially allowing the coronavirus to infect cells more easily.
“A virus that was substantially more fit to infect more people was the last thing we needed right now, and we’ve got it and it’s not going away,” he said.
“The only thing we can do is slow its spread.”
How bad is the situation with variants in Canada?
Canada’s Chief Public Health Officer Dr. Theresa Tam said Friday officials “continue to monitor” the spread of the variants in Canada, with at least 25 known cases to date.
Ontario has already identified 14 cases of B117, three of which have no known link to international travel. That prompted concerns from officials it could already be driving spread more than detected in hard-hit regions of the province.
“If that’s confirmed, we have evidence then of community transmission and that is a very serious concern that the vaccine will not be able to address quickly enough,” Dr. Barbara Yaffe, Ontario’s associate chief medical officer of health, said this week. “It’s very likely that we have more that we’re not aware of.”
Dr. Adalsteinn Brown, dean of the University of Toronto’s Dalla Lana School of Public Health and co-chair of Ontario’s COVID-19 science advisory table, said if B117 continues to spread in Ontario the rate of new cases could rise to “scary,” “almost near-vertical” levels.
“I wouldn’t be surprised if by the time we prove that there is community transmission definitively, it’s already spread like wildfire,” said Hota. “It’s just the nature of the beast.”
Brown added the variant could already be driving “a very dramatic growth in cases” in certain parts of the province, similar to the way it did in the United Kingdom despite strict public health restrictions.
WATCH | Ontario issues stay-at-home order amid dire COVID-19 projections:
“What we’re detecting is likely only the tip of the iceberg,” said Dr. Sumon Chakrabarti, an infectious disease specialist at Trillium Health Partners in Mississauga, Ont. “We absolutely cannot discount the possibility that it is here and it’s already having some kind of influence on the spread.”
British Columbia identified its first case of the variant first found in South Africa on Thursday, in addition to four previously discovered cases of B117.
Provincial Health Officer Dr. Bonnie Henry said Thursday officials are investigating how the latest case became infected with the variant, due to the fact that they also had no known link to travel.
“It is, of course, concerning we don’t know where this arose,” she said, signalling the variants could be spreading more widely in the community.
Five cases of B117 have also been confirmed in Alberta, along with one case of the variant first discovered in South Africa, but officials say all of those cases are travel-related.
Dr. Howard Njoo, Canada’s deputy chief public health officer, said during a press conference Thursday that the mutation of the coronavirus is “normal” and that the “emergence of variants is not unusual or unexpected.”
WATCH | WHO says new U.K. studies confirm variant of COVID-19 more transmissible:
He added that while Canada initially stopped all flights from the UK over fears the variant could spread here, that ban was lifted last week in favour of mandating all travellers into the country present a negative COVID-19 test.
On Friday, scientists with the U.S. Centers for Disease Control and Prevention (CDC) released modelling data that warned by March, B117 could become the dominant strain in the United States.
Jason Kindrachuk, an assistant professor of viral pathogenesis at the University of Manitoba and Canada Research Chair of emerging viruses, said he’s concerned Canada may be unprepared for cases of the variant increasing “underneath the surface.”
“We can’t judge when there’s going to be that sudden rise,” he said.
“You get a sense of the storm that could be coming and you’re watching that tsunami warning getting louder and louder — we need to be ready for this.”
Kindrachuk says the fact B117 took over as a main circulating strain in Ireland, England and Denmark in just a matter of weeks is “gravely concerning” for Canada because of the risk it could spread more widely here.
“The increases in cases we’re seeing right now are already concerning, but that’s not due to the variants,” he said. “So what happens when the variants start to take hold in different regions?”
Saskatchewan is the only province that currently says all of its COVID-19 testing will detect the B117 variant, while other provinces said that they only send positive test samples for further scrutiny if the context warrants.
“We’re not necessarily picking up on the cases of the known variants,” said Hota. “There may be other variants that are evolving as well under our noses.”
“The bottom line is, you don’t want to be stuck in a situation where by the time you have that information, it’s already your dominant strain.”
While efforts are underway to find a quicker way to test for variants, the current “deep sequencing” required is both expensive and time consuming — taking days to over a week to get results, said Dr. Zain Chagla, an infectious diseases physician at St. Joseph’s Healthcare in Hamilton, Ont.
What can be done to prevent the spread of variants?
While many of the public health guidelines recommended to stop the spread of the coronavirus are thought to be effective against the variants, experts say we should be doubling down on them and avoiding risky situations.
“Think of it this way, we don’t need to do more of the same — we need to do better of the same,” Dr. Tom Frieden, the former director of the CDC told CBC News. “It’s all about limiting risk.”
Physical distancing, mask wearing, hand hygiene and avoiding crowds are all effective, but Frieden says people should also reduce their time spent indoors with those they don’t live with, wear better quality masks such as N95s or surgical masks and have as few in-person interactions with others as possible.
WATCH | What scientists know about the new coronavirus variant (Jan. 8):
Frieden said that means, if possible, spending a few minutes in the grocery store to pick up essential items, or ordering online, as opposed to going in for an extended period to shop.
“In the past, with the earlier strain it was harder to get infected with it — you might have been in the same room, you might have been the same distance, and you would have evaded it,” said Topol. “But now, this has a more aggressive ability to infect.”
Frieden said at a population level, countries like Canada should focus on vaccinating as many people as they can as quickly as possible — especially older age groups and long-term care residents.
“Vaccines are enormously important. They’re the single most powerful tool that we have,” he said, “but a vaccination program is going to take a long time to go out.”
“The more we don’t take precautions, the more we can see explosive exponential spread.”
To read the entire Second Opinion newsletter every Saturday morning, subscribe by clicking here.
Canada records over 6,800 new COVID-19 cases as officials announce vaccine delay – Global News
Canada added over 6,800 new cases of the novel coronavirus Friday as federal officials revealed that vaccine shipments to the country would be delayed for four weeks over production issues.
In a press conference Friday, Procurement Minister Anita Anand said that only half of Pfizer-BioNTech’s promised COVID-19 vaccine doses would arrive in the next month.
The delay, which would impact production for a “short period” according to her, would be made up by the end of March and was due to the company scaling up its manufacturing capacity for European countries.
“This expansion work means that Pfizer is temporarily reducing deliveries to all countries receiving vaccine manufactured at its European facility — and that includes Canada,” said Anand, who reassured that the setback would not impact Canada’s long-term vaccination plan.
How will I know it’s my turn to get the vaccine? Your COVID-19 questions answered
Several provincial leaders including Saskatchewan Premier Scott Moe, B.C.’s Health Minister Adrian Dix and Ontario Premier Doug Ford have since raised concern over the delay, as a second shot of the Pfizer vaccine is expected to be administered within 21 days of the first for it to achieve maximum efficacy.
News of the delay also comes amid new federal COVID-19 modelling that showed the country was on track to surpass 10,000 new cases of the virus a day by February if Canadians kept maintaining the “current number of people we contact each day.”
Chief public health officer Dr. Theresa Tam, who presented the modelling at a media conference, said that the rise in new infections was largely due to Canadians gathering during the holidays.
According to her, current measures would have to be “further intensified” in order to curb the virus’ spread.
According to the modelling, virus cases could potentially surge past 30,000 a day if Canadians increased their current contacts each day by February.
“If we ease measures too soon the epidemic will resurge even more strongly,” said Tam.
Coronavirus: Canada’s deliveries of Pfizer vaccine hit by ‘temporary delay,’ Anand says
As of Friday evening, cases of COVID-19 in Canada floated at just under the 700,000 mark, though a total of 601,000 people have since recovered. Deaths linked to COVID-19 now stand at 17,729 after another 192 fatalities were reported.
To date, more than 20,238,921 tests have been administered and at least 765,100 doses of the vaccine have been distributed across Canada.
Ontario reported the highest number of infections Friday with another 2,998 cases as well as 100 deaths, though 46 of those deaths were reported to have occurred earlier in the pandemic.
Quebec added another 1,918 cases Friday as well as another 62 deaths. More than 8,900 deaths have now been recorded in the province, which is the hardest hit in Canada.
Health officials in B.C. announced another 500 lab-confirmed cases Friday as well, pushing the province’s official caseload to 59,583. Another 534 cases are considered “epi-linked,” which are cases that displayed symptoms and were in close contacts of confirmed cases but were never tested.
Nine of those epi-linked cases were included Friday’s count.
Another nine people were reported to have died from the virus there, with the province’s current death toll standing at 1,047.
Coronavirus: Hajdu says Health Canada would need to approve change in Pfizer manufacturing site
Alberta added another 785 cases Friday, pushing its total caseload to 115,370. The province’s death toll from the virus also stands at 1,402 after 21 more deaths were announced.
Saskatchewan reported another 386 cases and four more deaths, while Manitoba recorded 191 infections and five more fatalities.
Several provinces in Atlantic Canada also reported new cases of the virus Friday.
New Brunswick added another 25 cases, Nova Scotia two more and Newfoundland and Labrador another infection. P.E.I. did not report any new cases Friday.
In Canada’s North, only the Northwest Territories reported one case of the virus.
Coronavirus: Trudeau comments on strengthening COVID-19 travel measures
The country’s increase in cases also comes amid another grim milestone as over two million people worldwide were reported to have succumbed to the virus since the start of the pandemic, according to Johns Hopkins University.
To date, more than 93,751,000 people have been diagnosed with COVID-19, with the U.S., India and Brazil continuing to lead in both infections and deaths.
— With files from The Canadian Press and Global News’ Rachel Gilmore and Katie Dangerfield.
© 2021 Global News, a division of Corus Entertainment Inc.
Canada's coming month of Pfizer COVID-19 vaccine shipments will be reduced by half – CTV News
Over the next month Canada will be experiencing a “temporary” delay in Pfizer-BioNTech vaccine shipments due to the pharmaceutical giant’s expansion plans at its European manufacturing facility, with the shortage resulting in an average of 50 per cent of coming doses delayed each week.
While shipments will continue in the coming weeks, the amount of doses in them will be lessened, sometimes by hundreds of thousands of doses.
“Pfizer has confirmed that Canada’s deliveries will be impacted for the next four weeks. We will see an average reduction over this timeframe of 50 per cent of expected deliveries. There will minimal impact next week… The most profound impact will be in the week of January 25,” said Maj.-Gen. Dany Fortin, who is leading Canada’s logistical rollout.
This setback to Canada’s short-term COVID-19 vaccine delivery schedule means the number of doses going to each province and territory will have to be readjusted. Fortin said that the allocations will begin to scale back up in the first two weeks of February, before returning to the size of doses originally anticipated.
Canada was planning on receiving between 124,800 and 366,600 Pfizer doses every week between now and the end of February, as part of the plan to have six million doses total from Pfizer and Moderna by the end of March when Phase 1 ends.
The delivery for the week of Jan. 25, which Fortin said is likely to see the largest reduction, was set to be 208,650 doses. If that’s reduced by half, Canada will receive 104,325 Pfizer doses that week, which is fewer than the forecasted allocation received this week.
“In my conversation this morning with Pfizer, it was very clear that we’re are still correct in our planning assumption to receive approximately four million doses of Pfizer by March 31,” Fortin said,
Fortin said that knew the company would at some point need to scale-up their manufacturing to ramp-up its mass production, but the news of the looming construction project was brought to the federal government’s attention in the last 24 hours, according to Treasury Board President Jean-Yves Duclos.
Procurement Minister Anita Anand announced the delay on Friday, saying all nations who are receiving vaccines from this Pfizer facility will be receiving fewer doses.
“It is a temporary reduction, it’s not a stoppage… We will make up those doses,” Anand said.
Addressing the setback during his Rideau Cottage address on Friday, Prime Minister Justin Trudeau said that shipments have largely been ahead of schedule so far, but that “with an undertaking this historic, it’s only to be expected that there will be a few bumps along the way.”
Norway, which is also receiving Pfizer doses from its Europe facilities has announced that “for some time ahead” their deliveries will be reduced. In the coming week their shipment will be reduced by approximately 18 per cent.
“The reduction is due to a reorganisation at Pfizer in connection with an upgrade of production capacity… It is not yet clear how long it will take before Pfizer is up to maximum production capacity again,” said the statement published by the Norwegian Institute of Public Health.
The government sought to ensure that all countries who will be impacted, will be “equitably treated” in terms of delivery reductions, according to Anand. Fortin confirmed later Friday that this will be the case, with all seeing deliveries reduced by 50 per cent on average.
Anand said that while Canada is expecting to be able to catch up, the delay is “unfortunate.”
“However such delays and issues are to be expected when global supply chains are stretched well beyond their limits,” Anand said.
By end of the day Friday, the federal government will have distributed a total of 929,000 doses of the two approved COVID-19 vaccines, around 84 per cent of which have been administered.
WON’T IMPACT PHASE 2
The plan is to receive “more than” one million doses of approved vaccines every week, on average, starting in April with Phase 2.
Trudeau said that while this issue is out of Canada’s hands, the country “must still get ready for the ramp-up,” in Phase 2.
Fortin said the delays “will not change our second quarter goals,” though he could not guarantee future delays. He said he understands and feels the “disappointment,” but “we need to move forward.”
He committed to keep all key stakeholders, and Canadians appraised of any future delivery schedule changes.
The ongoing initial vaccination stage has seen Canada pushing to properly allocate and prioritize key groups like residents and staff in long-term care homes as well as front-line health-care workers.
In this first stage of the vaccine campaign, Canada has seen both doses sitting in freezers as well as provinces saying they are running short, while those on the front line have sought to sort out who should and shouldn’t be receiving shots at this time.
“It was with precisely these types of issues in mind that Canada pursued the aggressive procurement strategy that we did,” Anand said. “This approach of ensuring diversity and volume months ago is what now gives us flexibility and margins to remain on track in difficult times.”
Asked whether Canada will be looking to revisit their decision to not procure additional Moderna doses to make up the shortage over the next few weeks, Fortin said the amount scheduled to arrive from that company will stay the same.
As previously reported, the additional 16 million Moderna doses that the federal government left on the table in talks with that company would not be arriving until late 2021.
As for whether Canada looked into being able to receive Pfizer shipments from the United States facility, Fortin said that the federal government looked into it, but for now Canada’s line of doses will continue to come exclusively from the European facility.
Health Minister Patty Hajdu added that because as part of the regulatory approval granted to Pfizer, Health Canada approves the manufacturing sites as well as the vaccine itself.
“So, should we procure from even the same company a different site, then there would need to be review of the manufacturing data,” she said.
Several federal officials sought to reassure Canadians Friday that the country remains on track to vaccinate everyone who wants to be, by the end of September.
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