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Western Canada: B.C. faces vaccine shortfall amid rising cases of COVID-19 variants – The Globe and Mail

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Good morning. Wendy Cox in Vancouver this morning.

As the number of vaccines ramps up across the country, provinces are scrambling to boost their own efforts to get doses into arms. The increased availability of doses is still falling far short of the demand.

British Columbia finally opened its online registration portal on Tuesday, allowing people born in 1950 or earlier to register to get a confirmation code. The code allows them to book an appointment for a shot when they are contacted by e-mail, text or phone.

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But the continued scarcity of the resource was underlined even as British Columbia received more vaccines over the weekend and into this week. About 700,000 British Columbians between the ages of 55 and 65 can expect a chance to book a COVID-19 vaccine at their local pharmacy by the end of the week, but only about 200,000 doses of AstraZeneca are expected to be available.

Meantime, the 300,000 front-line workers who were promised priority access to that stream of vaccine supply in mid-March still have no answers about when they will be back in line as Canadian health officials reconsider the safety of the vaccine for younger populations.

“We do not have enough vaccine to provide it to everybody, but it’s a way of jump-starting that part of the age group,” Bonnie Henry, B.C.’s Provincial Health Officer, said Tuesday.

Meantime, case counts across the country continue to surge, driven by highly contagious variants.

“On present course, the pandemic will blight the spring and shorten the summer for millions of Canadians,” said David Naylor, the co-chair of the federal COVID-19 Immunity Task Force.

The surge “cannot be contained without tough public health measures and a substantial acceleration of the current vaccine rollout.”

Alberta brought in new measures Tuesday, announcing it would reimpose restrictions on restaurants, gyms and other activities as more transmissible and lethal variants spread without restraint.

Premier Jason Kenney said the province will return to the first phase of its reopening plan as Alberta forecast 1,000 people with COVID-19 will be in hospital by the end of the month. Restaurants will be closed for indoor dining as of Friday and gyms must stop group activities Wednesday. Retailers and shopping malls must reduce capacity to 15 per cent of fire code, down from 25 per cent.

Alberta’s retreat comes less than a month after Mr. Kenney bowed to pressure from inside his own caucus to loosen the rules. But the variants of concern, which now make up about 43 per cent of Alberta’s 10,809 active cases, are undoing progress to contain infections and threaten to overwhelm the health care system. Alberta projected 2,000 new daily cases of COVID-19 by the end of the month.

“We must defeat these variants,” Mr. Kenney said. “This wave is here.”

Cases are also climbing in British Columbia, but new restrictions weren’t imposed here.

B.C. posted another 1,068 new cases of COVID-19 on Tuesday, and the province identified more than 200 new cases involving the variants of concern. Health officials blame the rise in cases on social interactions and non-essential travel in defiance of health orders, and expressed alarm at the rising number of younger residents who are now in hospital. Restaurants and bars have been closed for in-dining service since March 30.

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Health Minister Adrian Dix urged British Columbians to follow the existing rules while the mass vaccination program continues to roll out.

On Monday, federal Health Minister Patty Hajdu highlighted the discrepancies between the available shots and the number administered, but on Tuesday she and Prime Minister Justin Trudeau were careful not to directly criticize the premiers.

“We all need to speed up the vaccination process,” Mr. Trudeau said in French.

Ms. Hajdu was not able on Tuesday to say how quickly the federal government expects provinces to administer vaccines once they receive them. The federal public health agency wasn’t able to provide data on how fast shots are being given, and neither were provinces such as Ontario and B.C.

That information is crucial to ensuring an effective vaccination campaign, Dr. Naylor said.

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“You absolutely have to have a sense of your inventory and how fast it’s moving so that you can determine how sites are performing relative to the demand they’re facing,” he said.

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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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