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Why provinces and territories 'jump the gun' on Canada's COVID-19 vaccine guidance – CBC.ca

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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.


Canada’s vaccine advisory committee has given advice that’s repeatedly been proven right throughout the pandemic — in the face of limited data and vocal criticism — and saved lives.

But multiple medical experts say the failure to do so quickly and transparently threatens to undermine public confidence on key vaccine issues and forces provinces to make crucial decisions on their own.

The National Advisory Committee on Immunization (NACI) released new guidelines on booster shots Friday — after weeks of deliberation — strongly recommending them for those over 80 and leaving the door open to others at risk of lowered vaccine protection.

But the NACI recommendations came after a handful of provinces and territories across Canada already announced their own plans for booster shots, calling into question the speed in which the committee can react to emerging evidence and issue national advice.

“It’s fair to say that NACI has come up with some excellent recommendations,” said Dr. Isaac Bogoch, an infectious diseases physician and member of Ontario’s COVID-19 vaccine task force.

“But it would be very helpful to have these recommendations faster.” 

Provinces, territories ‘jump the gun’ on NACI

B.C. pre-empted NACI on Tuesday, rather than wait any longer for the committee’s highly anticipated guidance to be released, announcing its own plan to roll out boosters for everyone in the province by May 2022 that goes far beyond the committee’s approach.

Provincial Health Officer Dr. Bonnie Henry said in a phone interview the reason B.C.’s booster guidance came days earlier than NACI’s is because she wanted the province to have a “simple, longer term strategy that people will understand.” 

“What we’re seeing now on the ground here is breakthrough [infections] in the older people who went first,” she said. “So that’s why we needed to be more proactive to try to get out booster doses to those people right away.”

WATCH | Breakthrough COVID-19 infections cause confusion, concern:

Breakthrough COVID-19 cases bring confusion, concern

19 days ago

They only account for roughly 30 per cent of COVID-19 cases, but breakthrough infections are happening. The situation is confusing to the fully vaccinated who got the virus, and experts say the cases may be a worrisome signal. 4:13

The Northwest Territories offered boosters to everyone over the age of 18 on Thursday, and the Yukon will soon make them available to those over 50. Saskatchewan expanded boosters to Indigenous people over 50 and anyone over 65 and Alberta did the same for Indigenous people over 65 and anyone 75 or older earlier this month.

But this isn’t the first time NACI has been beaten to the punch. 

NACI previously recommended third doses for severely immunocompromised people who don’t generate strong initial responses to the vaccine — a different matter than booster shots that top up declining antibody levels — but even that guidance was pre-empted by some provinces. 

Ontario and Alberta began offering third shots for certain vulnerable groups including transplant recipients, cancer patients, immunocompromised individuals and long-term care residents weeks before NACI’s guidance finally came out in mid-September. 

And Quebec and British Columbia previously leapfrogged NACI’s guidance on delaying second doses and mixing and matching COVID-19 vaccines — opting to instead to release their own strategy rather than wait for the committee to act. 

Bogoch says there’s “no reason” why NACI shouldn’t be able to release recommendations sooner, but they need more resources to stay on top of emerging data and to avoid  “bureaucratic hurdles.” (It can take NACI a week to translate and upload its guidance online.)

“It would be very helpful if they had additional support, so that they can continue to do the excellent work that they do in a timely manner,” said Bogoch.  

“That way, you could avoid having provinces jump the gun and we can avoid a situation where we have 10 provinces and three territories doing things differently.” 

Lack of transparency ahead of ‘hot-button issues’ 

Another key area experts say NACI is falling behind on is transparent, open communication with Canadians and the media — especially as guidelines for sensitive topics like COVID-19 vaccines for children are expected to be released in the coming weeks.  

Unlike the U.S., where vaccine advisory committee meetings on key issues like booster shots and vaccines for kids are live-streamed online with questions from the public addressed, NACI meetings are held behind closed doors without public input. 

Helen Branswell, an infectious diseases journalist with STAT, said the U.S. approach of holding advisory committee meetings in public helps journalists and the public “understand what the concerns are” and “the thinking behind the decisions that are being made.” 

NACI also hasn’t held a press conference or taken questions directly from the media in months, since the departure of outspoken former NACI Chair Dr. Caroline Quach, and now opts for federal government spokespeople to comment on their guidance.

“It’s absolutely possible to have a more open process, but I think that people were not ready to try that in the middle of a pandemic,” Quach said in a phone interview.

“After the pandemic it’s possible that something more open will come, but it’s just that changing everything in the middle of a crisis is never the best idea.” 

NACI hasn’t held a press conference or taken questions directly from the media in months, since the departure of former NACI chair Dr. Caroline Quach, and now opts for federal government spokespeople to comment on their guidance. (Marc-André Lapierre)

But the independent advisory committee did ultimately opt to change its communication strategy in the middle of the pandemic — making it less accessible to the media, and less visible to the public as a result. 

The Public Health Agency of Canada (PHAC) has since taken over all of NACI’s media duties, with interview requests and questions for NACI forwarded directly to PHAC media relations staff and press briefings held by Dr. Theresa Tam and Dr. Howard Njoo on NACI’s behalf. 

“In principle, I have no problem with the decision to pass the communications mandate back to PHAC,” said Dr. David Naylor, who led the federal inquiry into Canada’s national response to the 2003 SARS epidemic and now co-chairs the federal government’s COVID-19 immunity task force. 

“In practice, however, I don’t think this approach is working optimally. And that’s a worry because we have some hot-button issues coming up fast.” 

Dr. David Naylor says there are ‘strong feelings’ on upcoming issues like vaccines for children and booster shots for the broader Canadian public, in addition to ‘gaps in the evidence’ that could lead to a ‘very polarized debate.’ (Jae C. Hong/Associated Press)

Naylor says there are “strong feelings” on upcoming issues like vaccines for children and booster shots for the broader Canadian public, in addition to “gaps in the evidence” that could lead to a “very polarized debate.”

“Whoever handles the communication on these fronts in the next few days and weeks needs to be fully committed and well prepared.”

WATCH | How communities work to get parents on board with COVID-19 vaccines for kids:

Communities work to get parents on board with COVID-19 vaccines for kids

3 days ago

Community groups are using some of the lessons they learned in overcoming COVID-19 vaccine hesitancy in adults to help parents on board with vaccinating their children. 2:05

Public spotlight ‘not sustainable’ for NACI

NACI is now far less open to discussing and explaining the reasoning behind its recommendations with the press and the public than it has been in the past — and that may be in part due to a change in leadership.

Unlike Quach, who is a professor of infectious diseases, immunology, microbiology  and pediatrics at the University of Montreal with a somewhat flexible schedule, current chair Dr. Shelley Deeks is also Nova Scotia’s public health surveillance medical officer of health.

“Vaccines have been politicized at times,” said Naylor. “And it’s possible that one factor in the change is that having a very senior provincial official as chief spokesperson for a federal panel could be a bit awkward at times.” 

A woman receives a booster dose of the Pfizer-BioNTech COVID-19 vaccine at Skippack Pharmacy in Schwenksville, Penn., on Aug. 14. (Hannah Beier/Reuters)

Quach says that once Deeks took over the role as NACI chair, the two of them agreed that keeping up the previous level of public press conferences and media interviews was “not sustainable.” 

“That flexibility wasn’t there anymore and so that’s really when NACI asked the Public Health Agency of Canada to take back all the press, all the communications,” Quach said. 

“I like giving media interviews — I don’t think Dr. Deeks likes it that much — and you can’t force her. She’s doing an amazing job as a chair of the committee but being a spokesperson was not part of her job description when she signed up for it.” 

When asked by CBC News why questions from the press must now be forwarded to PHAC, instead of being answered directly by the NACI chair like the many times it had done so in the past, Deeks responded by forwarding the question to PHAC.

A spokesperson for PHAC said the interest from the general public and the media in the “rationale, data and evidence” of NACI’s recommendations has increased throughout the pandemic, which is why NACI began participating in press briefings in the first place. 

“However, NACI is a committee that is comprised of volunteers whose time is very limited during a pandemic response,” the PHAC spokesperson said. 

“In order to allow NACI to focus on its important deliberations and advice to public health decision-makers and healthcare providers, PHAC is responsible for conveying this advice to the Canadian public and media.” 

Sabina Vohra-Miller, a pharmacologist and science communicator who co-founded Unambiguous Science and the South Asian Health Network, says NACI could benefit from a communications expert who could convey its recommendations to the public in a clear-cut way. 

“The kind of support they need is not silencing them. I don’t think their voice should be silenced. They have a very strong, very needed voice here in Canada,” she said. 

“We need to have that trustworthy, consistent voice speaking to the public. And frankly, I haven’t even seen that coming from the Public Health Agency of Canada either.” 

WATCH | PHAC says booster shots not needed for general population yet:

Tam says COVID-19 booster shot not required for general population right now

Dr. Theresa Tam, Canada’s chief public health officer, says there is no evidence at this time of any widespread reduction in protection for those who have received their COVID-19 vaccines. 2:04

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Canada joins diplomatic boycott of Beijing Games – CP24 Toronto's Breaking News

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Mia Rabson, The Canadian Press


Published Wednesday, December 8, 2021 12:43PM EST


Last Updated Wednesday, December 8, 2021 4:27PM EST

OTTAWA – Prime Minister Justin Trudeau says Canada will join a diplomatic boycott of the Winter Olympics in Beijing next year, citing extensive human rights abuses by the Communist regime in the host country.

The decision comes two days after the United States announced it would not send government officials to the Olympics over concerns about China’s human rights record, and particularly allegations of genocide against the Muslim Uyghur minority in the Xinjiang province.

Australia, New Zealand and the United Kingdom have all since followed suit.

Trudeau said Canada too is “extremely concerned by the repeated human rights violations by the Chinese government.”

“I don’t think the decision by Canada or by many other countries to choose to not send a diplomatic representation to the Beijing Olympics and Paralympics is going to come as a surprise to China,” he said Wednesday.

“We have been very clear over the past many years of our deep concerns around human rights violations and this is a continuation of us expressing our deep concerns for human rights violations.”

A diplomatic boycott means Canadian athletes can and will still compete but no government officials will attend, including Pascale St-Onge, the new minister of sport.

While it has been rare in recent years for the prime minister to attend an Olympics, Canada normally sends multiple government representatives including cabinet ministers and often the governor general.

Last summer, Employment Minister Carla Qualtrough represented the Canadian government at the delayed Tokyo Olympics. In 2018 in Pyeongchang, Trudeau requested then-governor general Julie Payette attend for Canada. Kirsty Duncan, then the sport minister, attended both the Olympics and Paralympics along with several staff members.

Former governor general David Johnston attended for Canada at the 2016 Summer Olympics in Rio de Janeiro and at the 2012 Summer Games in London.

There were some calls for countries to stage a boycott of the 2008 Summer Olympics in Beijing over human rights concerns, or at least to refuse to attend the opening ceremonies. But former prime minister Stephen Harper rejected that idea and sent his foreign affairs minister, David Emerson, to attend the games, including the opening ceremonies.

China denies allegations of human rights abuses and is accusing the United States of upending the political neutrality of sport. Chinese diplomats slammed the decisions by the U.S. and Australia, accusing countries of using the Olympics as a pawn, and adding several times that “nobody cares” whether diplomats attend the Games.

Mac Ross, a kinesiology professor at Western University’s International Centre for Olympic Studies, said Canada is sending a message to China and the International Olympic Committee that it “will not support the hosting of Olympic Games against the backdrop of widespread human rights violations.”

Ross also said China’s accusation that the boycotts politicize the Olympics ignores how many times China itself boycotted the Games.

“The People’s Republic of China has staged full boycotts of the Olympics multiple times, on purely political grounds,” Ross said. “Why are boycotts suddenly unacceptable? The answer is simple: they place the regime’s human rights record front and centre.”

In a written statement, Canadian Olympic Committee CEO David Shoemaker and Canadian Paralympic Committee CEO Karen O’Neill said they respect the decision made by the government.

“The Canadian Olympic Committee and Canadian Paralympic Committee remain concerned about the issues in China but understand the Games will create an important platform to draw attention to them,” they said. “History has shown that athlete boycotts only hurt athletes without creating meaningful change.”

The Chinese Embassy in Canada has not yet reacted to Canada’s decision, but tweeted ahead of the announcement that “the Beijing 2022 Winter Olympics are about athletic excellence and global unity. Stop using it as a platform for grandstanding and division.”

China threatened to take “countermeasures” against the U.S. but has not specified what that means.

Trudeau said Wednesday concerns about arbitrary detention of any foreign nationals by the Chinese government continues to be a concern but that Canada will do everything necessary to ensure the safety of Canadian athletes competing in Beijing.

“We know that our athletes need to have one thing in mind that is representing their countries to the best of their ability and winning that gold medal for Canada,” he said.

Foreign Affairs Minister Melanie Joly said the RCMP are always involved in ensuring security for Canada’s athletes and that Canada’s diplomatic missions in China will also be helping ensure the athletes have everything they need.

Canada’s diplomatic relationship with China is still strained following nearly three years of tension over China’s detention of two Canadians. Michael Kovrig and Michael Spavor were finally released from Chinese prison in September.

Canada always alleged they were detained in retaliation for its decision to arrest Huawei executive Meng Wanzhou at the request of the United States, which wanted her extradited there to face fraud charges.

The two Michaels, as Kovrig and Spavor came to be called, were freed the same day Meng struck a plea deal with the U.S. and was released from Canada.

Opposition Conservative Leader Erin O’Toole said he supports a diplomatic boycott but accused Trudeau of lagging behind Canada’s allies in making the decision.

This report by The Canadian Press was first published Dec. 8, 2021.

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Coronavirus: What's happening in Canada and around the world on Wednesday – CBC News

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The latest:

British Prime Minister Boris Johnson announced tighter restrictions Wednesday to stem the spread of the omicron variant, urging people in England to again work from home and mandating COVID-19 passes for entrance into nightclubs and large events.

Johnson said it was time to impose stricter measures to prevent a spike of hospitalizations and deaths as the new coronavirus variant spreads rapidly in the community.

“It has become increasingly clear that omicron is growing much faster than the previous delta variant and is spreading rapidly all around the world,” he said in a news conference. “Most worryingly, there is evidence that the doubling time of omicron could currently be between two and three days.”

Johnson said that 568 cases of the omicron variant have been confirmed across the U.K., and “the true number is certain to be much higher.”

He said beginning next Monday, people should work from home if possible. Starting on Friday, the legal requirement to wear a face mask will be widened to most indoor public places in England, including cinemas. Next week, having a COVID-19 pass showing that a person has had both vaccine doses will be mandatory to enter nightclubs and places with large crowds.

Overall, the British government reported another 51,342 confirmed daily cases of COVID-19 as of Wednesday, with 161 more people dying.

WATCH | Lawmakers blast Johnson over holiday party allegations: 

U.K. PM blasted over allegations of rule-breaking party

7 hours ago

Duration 3:15

‘How does the prime minister sleep at night?’ Labour MP asks as lawmakers blast Boris Johnson over holiday party allegations. (Credit: Reuters TV) 3:15

The announcement came as Johnson and his government faced increasing pressure to explain reports that Downing Street staff enjoyed a Christmas party that breached the country’s coronavirus rules last year, when people were banned from holding most social gatherings. Johnson on Wednesday ordered an inquiry and said he was “furious” about the situation.

The revelations have angered many in Britain, with critics saying they heavily undermine the authority of Johnson’s Conservative government in imposing virus restrictions.

-From The Associated Press, Reuters and CBC News, last updated at 2:55 p.m. ET


What’s happening across Canada

WATCH | Tracking Canada’s 1st home-grown COVID-19 vaccine: 

The importance of Canada’s 1st home-grown COVID-19 vaccine

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Duration 4:52

Quebec company Medicago is getting ready to submit data about its COVID-19 vaccine for final regulatory approval, which is a significant step for the pandemic and Canada’s bio-pharmaceutical industry. 4:52


What’s happening around the world

As of Wednesday afternoon, more than 267.5 million cases of COVID-19 had been reported worldwide, according to Johns Hopkins University, which maintains an online database of global cases. The reported global death toll stood at more than 5.2 million.

Children stand near a statue on a crowded street in Madrid on Wednesday as many pedestrians wear masks to protect themselves against COVD-19. (Susana Vera/Reuters)

The World Health Organization (WHO) warned Wednesday that governments need to reassess national responses to COVID-19 and speed up vaccination programs to tackle the omicron variant, though it is too early to say how well existing shots will protect against it.

The variant’s global spread suggests it could have a major impact on the pandemic, and the time to contain it is now before more omicron patients are hospitalized, WHO director-general Tedros Adhanom Ghebreyesus said.

“We call on all countries to increase surveillance, testing and sequencing,” he told a media briefing. “Any complacency now will cost lives.”

In Europe, France’s Ile-de-France region — with the capital Paris at its centre — said all hospitals are activating an emergency plan due to the strained COVID-19 situation. The plan includes stepping up the number of ICU beds and, if necessary, rescheduling treatments to free up capacities.

Meanwhile, European Union health ministers discussed measures to try to halt the spread of the omicron variant, with the Netherlands calling for negative tests for incoming travellers from outside the bloc and France urging tests even for those arriving from EU states.

Poland and several other countries in central and eastern Europe are battling their latest surges of coronavirus cases and deaths while continuing to record much lower vaccination rates than in western Europe.

In Russia, more than 1,200 people with COVID-19 died every day throughout most of November and for several days in December, and the daily death toll remains over 1,100. Ukraine, which is recording hundreds of virus deaths a day, is emerging from its deadliest period of the pandemic.

A health-care worker gives a booster shot against COVID-19 in Warsaw on Tuesday. (Czarek Sokolowski/The Associated Press)

Meanwhile, the mortality rate in Poland — while lower than it was in the spring — recently hit more than 500 deaths per day and still has not peaked. Intensive care units are full, and doctors report that more children require hospitalization, including some who went through COVID-19 without symptoms but then suffered strokes.

The situation has created a dilemma for Poland’s government, which has urged citizens to get vaccinated but clearly worries about alienating voters who oppose vaccine mandates or any restrictions on economic life.

In the Americas, the number of Americans fully vaccinated against COVID-19 reached 200 million Wednesday amid a dispiriting holiday-season spike in cases and hospitalizations that has hit even New England, one of the most highly inoculated corners of the country. 

WATCH | U.S. could reach over 800,000 deaths by 2022: 

U.S. on track for over 800,000 COVID-19 deaths before 2022

19 hours ago

Duration 1:57

COVID-19 cases in the United States are on the rise, with the country on track to record more than 800,000 deaths by the end of the year. The White House is pushing vaccinations over lockdowns, but some Canadian health units are cautioning against non-essential travel to parts of the U.S. 1:57

Brazil will require that unvaccinated travellers entering the country go on a five-day quarantine followed by a COVID-19 test, after its president said he opposed the use of a vaccine passport.

In Africa, South Africa reported nearly 20,000 new COVID-19 cases Wednesday, a record since the omicron variant was detected, and 36 new COVID-related deaths. It was not immediately clear how many of the infections were caused by omicron, given only a fraction of samples are sequenced, but experts believe it’s driving South Africa’s fourth wave of infections.

A weekly epidemiological report published Tuesday by WHO said that in the Middle East, the most cases reported last week were in:

  • Jordan, with 32,108 reported cases.
  • Iran, with 26,255 reported cases.
  • Lebanon, with 10,406 reported cases.

In the Asia-Pacific region, South Korea will consider expanding home treatment of COVID-19 patients, as both new daily infections and severe cases hit record highs, putting hospital capacity under strain.

-From Reuters, The Associated Press and CBC News, last updated at 4:05 p.m. ET

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U.S. Senator asks FTC to probe Facebook’s ad practices

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U.S. Senator Maria Cantwell on Wednesday asked the Federal Trade Commission to investigate whether Meta Platforms’ Facebook misled its advertising customers and the public about the reach of its advertisements, according to a letter to FTC Chair Lina Khan.

“I urge the FTC to immediately commence an investigation into Facebook’s representations with respect to brand safety, Potential Reach, and similar metrics with respect to its advertising business and, if that investigation reveals that the company has in fact violated the law, to pursue all available sanctions as appropriate,” the letter said.

 

(Reporting by Chris Sanders; editing by Diane Craft)

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