Canada is falling behind in its initial rollout of COVID-19 vaccines at a critical time in the pandemic, and experts say our most vulnerable populations are being left at risk.
Despite having months to prepare for the deployment of the initial shipment of vaccines to those most threatened by COVID-19 in long-term care facilities, a consistent rollout plan has yet to fully materialize on the ground.
“It just seems to be chaos right now,” said Alyson Kelvin, an assistant professor at Dalhousie University and a virologist at the Canadian Centre for Vaccinology evaluating Canadian vaccines with the VIDO-InterVac lab in Saskatoon.
“We know who is a vulnerable population, so we need a strategy of actually vaccinating them.”
Long-term care residents were largely left out of Canada’s initial rollout of the Pfizer-BioNTech vaccine, which requires storage temperatures of –80 to –60 C, in favour of waiting for the more easily transportable Moderna vaccine and vaccinating health-care workers first.
But once thawed, the Pfizer-BioNTech vaccine can be used for up to five days at basic refrigeration temperatures — meaning it could be taken out of distribution hubs across the country and brought into long-term care facilities directly during that window of time.
A registered pharmacy technician prepares COVID-19 vaccines in Toronto on Dec. 15. (Evan Mitsui/CBC)
“We treated the Pfizer vaccine with as much care and respect as possible and that really created all these hub sites,” said Dr. Zain Chagla, an infectious diseases physician at St. Joseph’s Healthcare Hamilton and an associate professor at McMaster University. “And I think that did hinder some of the innovation and the ability to do things elsewhere.”
Fragmented rollout across Canada a ‘failure’
The federal government has deployed almost 500,000 doses of both the Pfizer-BioNTech and Moderna vaccines to distribution sites across the country since mid-December, but the actual rollout of vaccinations is up to the individual provinces and territories.
Quebec took the bold step of actually putting its vaccine distribution centres inside long-term care facilities, making it easier to inoculate residents as quickly as possible.
While British Columbia made the decision to move the Pfizer-BioNTech vaccine from its distribution sites almost immediately into long-term care homes to inoculate residents and staff upon receiving its first doses.
Andy Yoon, 77, of Abbotsford, B.C., became the first long-term care resident in the Fraser Health region to receive the COVID-19 vaccine on Dec. 24. (Submitted by Fraser Health)
Yet Ontario decided against bringing the Pfizer-BioNTech vaccine directly into long-term care homes initially, despite other provinces doing so, and is only now doing so more than three weeks after receiving its first shipment.
Dr. Vera Etches, Ottawa’s medical officer of health, announced Tuesday the city would be transporting the Pfizer-BioNTech vaccine out of its distribution hub at the Ottawa Hospital and directly into long-term care residences, after vaccine-handling criteria from Pfizer were changed.
Despite receiving 53,000 doses of the Moderna vaccine last week, which is much easier to bring into long-term care residences, only 3,000 doses have actually been administered in Ontario as of Tuesday.
Ontario has pledged to vaccinate all residents, health-care workers and essential caregivers at long-term care homes in the hardest hit regions of Toronto, Peel, York and Windsor-Essex by Jan. 21, but has not set a deadline for the rest of the province.
To date, fewer than 1,000 long-term care residents have been vaccinated in Ontario.
“The provincial health-care systems aren’t experts in newly emerging viruses, brand new speedy vaccine platforms and pandemics,” said Kelvin. For that reason, ongoing communication from the federal government to the provinces and territories and local level is essential, she said.
“To leave each province and territory to have to come up with their own plan, when they’re not experts in this, I think is a failure.”
Kelvin said putting experts with relevant backgrounds in long-term care at the helm of vaccine rollouts across the country could have mitigated some of the missteps made so far.
“We need somebody who’s knowledgeable about long-term care facilities in Canada and their current functioning states,” she said.
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Chagla said Ontario could have either proactively opened up more vaccine distribution centres, or used the five-day model of thawing the Pfizer-BioNTech vaccine and getting it directly into long-term care facilities in order to vaccinate those most at risk sooner.
‘Rules are made to be broken’
Dr. Allison McGeer, a medical microbiologist and infectious disease specialist at Toronto’s Mount Sinai Hospital who worked on the front lines of the SARS epidemic in 2003, says provinces need to be much more flexible in how they roll out the vaccines.
“You want to do what got done in studies, because you know what the outcome of studies were,” she said, referring to the clinical trial data for both COVID-19 vaccines.
“However, this is a pandemic and rules are made to be broken.”
Quebec and Manitoba decided not to reserve second doses for those who had received their first shot in an effort to speed up their vaccination campaigns, while Ontario has asked Health Canada to “look into” the possibility of providing Moderna’s vaccine as a single dose.
McGeer said Canada should be focused on the most effective way to use the vaccines it has in hand, as opposed to letting them sit in freezers, even if that doesn’t always line up entirely with the usage guidelines.
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She said that includes being open to the possibility of administering more initial doses to people as quickly as possible and spacing the second doses differently over a longer period of time.
“While we have to be careful with messing with what we’re doing with vaccines, we also really want to be focused on the most protection for the largest amount of people in the shortest period of time,” she said.
“And that definitely means being open to half doses, spreading doses further apart, mixing vaccines.”
Chagla agrees there are ways to pick up the pace that could be considered, including prioritizing giving people their first dose without reserving their second.
“But I don’t think we’re even at that point yet,” he said. “We just need to start getting the logistics up, and again, using the supply we have before we start reconsidering.”
The U.K. has come under fire for its decision to stretch the interval between doses to up to three months, as opposed to the recommended three to four weeks, and for opening the door to giving a person doses of two different vaccines.
Israel has made the decision to use up its initial supply of COVID-19 vaccines as quickly as possible in order to vaccinate as many people with the initial doses it has, with more than two million people set to get a shot by the end of the month.
“We need to be open to the concept that the way [the vaccines] were studied is not necessarily the best way to use them in the middle of a pandemic,” said McGeer.
“In Ontario, it actually doesn’t matter, because we’re so far behind in delivering vaccine that we could give second doses to everybody that’s had a first dose and we wouldn’t make a dent in our vaccine supply.
Nova Scotia RCMP say their investigation into two suspicious deaths earlier this month has concluded that one man died by homicide and the other by suicide.
The bodies of two men, aged 40 and 73, were found in a home in Windsor, N.S., on Sept. 3.
Police say the province’s medical examiner determined the 40-year-old man was killed and the 73-year-old man killed himself.
They say the two men were members of the same family.
No arrests or charges are anticipated, and the names of the deceased will not be released.
RCMP say they will not be releasing any further details out of respect for the family.
This report by The Canadian Press was first published Sept. 16, 2024.
For the first time in their history, members of the Cree community of Nemaska received a visit from a sitting Quebec premier on Sunday and were able to share first-hand the story of how they were displaced by a hydroelectric project in the 1970s.
François Legault was greeted in Nemaska by men and women who arrived by canoe to re-enact the founding of their new village in the Eeyou Istchee James Bay region, in northern Quebec, 47 years ago. The community was forced in the early 1970s to move from its original location because members were told it would be flooded as part of the Nottaway-Broadback-Rupert hydro project.
The reservoir was ultimately constructed elsewhere, but by then the members of the village had already left for other places, abandoning their homes and many of their belongings in the process.
George Wapachee, co-author of the book “Going Home,” said community members were “relocated for nothing.”
“We didn’t know what the rights were, or who to turn to,” he said in an interview. “That turned us into refugees and we were forced to abandon the life we knew.”
Nemaska’s story illustrates the challenges Legault’s government faces as it looks to build new dams to meet the province’s power needs, which are anticipated to double by 2050. Legault has promised that any new projects will be developed in partnership with Indigenous people and have “social acceptability,” but experts say that’s easier said than done.
François Bouffard, an associate professor of electrical engineering at McGill University, said the earlier era of hydro projects were developed without any consideration for the Indigenous inhabitants living nearby.
“We live in a much different world now,” he said. “Any kind of hydro development, no matter where in Quebec, will require true consent and partnership from Indigenous communities.” Those groups likely want to be treated as stakeholders, he added.
Securing wider social acceptability for projects that significantly change the landscape — as hydro dams often do — is also “a big ask,” he said. The government, Bouchard added, will likely focus on boosting capacity in its existing dams, or building installations that run off river flow and don’t require flooding large swaths of land to create reservoirs.
Louis Beaumier, executive director of the Trottier Energy Institute at Polytechnique Montreal, said Legault’s visit to Nemaska represents a desire for reconciliation with Indigenous people who were traumatized by the way earlier projects were carried about.
Any new projects will need the consent of local First Nations, Beaumier said, adding that its easier to get their blessing for wind power projects compared to dams, because they’re less destructive to the environment and easier around which to structure a partnership agreement.
Beaumier added that he believes it will be nearly impossible to get the public — Indigenous or not — to agree to “the destruction of a river” for a new dam, noting that in recent decades people have come to recognize rivers as the “unique, irreplaceable riches” that they are.
Legault’s visit to northern Quebec came on Sept. 15, when the community gathers every year to remember the founding of the “New Nemaska,” on the shores of Lake Champion in the heart of the boreal forest, some 1,500 kilometres from Montreal. Nemaska Chief Clarence Jolly said the community invited Legault to a traditional feast on Sunday, and planned to present him with Wapachee’s book and tell him their stories.
The book, published in 2022 along with Susan Marshall, is filled with stories of Nemaska community members. Leaving behind sewing machines and hunting dogs, they were initially sent to two different villages, Wapachee said.
In their new homes, several of them were forced to live in “deplorable conditions,” and some were physically and verbally abused, he said. The new village of Nemaska was only built a few years later, in 1977.
“At this time, families were losing their children to prison-schools,” he said, in reference to the residential school system. “Imagine the burden of losing your community as well.”
Thomas Jolly, a former chief, said he was 15 years old when he was forced to leave his village with all his belongings in a single bag.
Meeting Legault was important “because have to recognize what happened and we have to talk about the repercussions that the relocation had on people,” he said, adding that those effects are still felt today.
Earlier Sunday, Legault was in the Cree community of Eastmain, where he participated in the official renaming of a hydro complex in honour of former premier Bernard Landry. At the event, Legault said he would follow the example of his late predecessor, who oversaw the signing of the historic “Paix des Braves” agreement between the Quebec government and the Cree in 2002.
He said there is “significant potential” in Eeyou Istchee James Bay, both in increasing the capacity of its large dams and in developing wind power projects.
“Obviously, we will do that with the Cree,” he said.
This report by The Canadian Press was first published Sept. 16, 2024.
NEMASKA – For the first time in their history, members of the Cree community of Nemaska received a visit from a sitting Quebec premier on Sunday and were able to share first-hand the story of how they were displaced by a hydroelectric project in the 1970s.
François Legault was greeted in Nemaska by men and women who arrived by canoe to re-enact the founding of their new village in the Eeyou Istchee James Bay region, in northern Quebec, 47 years ago. The community was forced in the early 1970s to move from their original location because they were told it would be flooded as part of the Nottaway-Broadback-Rupert hydro project.
The reservoir was ultimately constructed elsewhere, but by then the members of the village had already left for other places, abandoning their homes and many of their belongings in the process.
George Wapachee, co-author of the book “Going Home,” said community members were “relocated for nothing.”
“We didn’t know what the rights were, or who to turn to,” he said in an interview. “That turned us into refugees and we were forced to abandon the life we knew.”
The book, published in 2022 by Wapachee and Susan Marshall, is filled with stories of Cree community members. Leaving behind sewing machines and hunting dogs, they were initially sent to two different villages, 100 and 300 kilometres away, Wapachee said.
In their new homes, several of them were forced to live in “deplorable conditions,” and some were physically and verbally abused, he said. The new village of Nemaska was only built a few years later, in 1977.
“At this time, families were losing their children to prison-schools,” he said, in reference to the residential school system. “Imagine the burden of losing your community as well.”
Legault’s visit came on Sept. 15, when the community gathers every year to remember the founding of the “New Nemaska,” on the shores of Lake Champion in the heart of the boreal forest, some 1,500 kilometres from Montreal. Nemaska Chief Clarence Jolly said the community invited Legault to a traditional feast on Sunday, and planned to present him with Wapachee’s book and tell him their stories.
Thomas Jolly, a former chief, said he was 15 years old when he was forced to leave his village with all his belongings in a single bag.
Meeting Legault was important “because have to recognize what happened and we have to talk about the repercussions that the relocation had on people,” he said, adding that those effects are still felt today.
Earlier Sunday, Legault had been in the Cree community of Eastmain, where he participated in the official renaming of a hydro dam in honour of former premier Bernard Landry.
This report by The Canadian Press was first published Sept. 16, 2024.
