Health care workers wait in line at a UHN COVID-19 vaccine clinic in Toronto on Jan. 7, 2021.Nathan Denette/The Canadian Press
Peter Doddy – 97 years old and one of the oldest surviving combat veterans of the Second World War – has a question for the country he served: “When will it be my turn?”
As our coronavirus vaccine rollout continues, slowly and unsurely, many Canadians are finding themselves asking the same question.
But it’s a little more urgent when you’re an almost-centenarian with chronic obstructive pulmonary disease – as well as a host of other conditions that come with age, like hearing loss, vision loss and risk of infection – who has been cooped up in the house for more than 10 months.
“My dad doesn’t want special treatment,” daughter Christine Prosser says. “Like everyone else, he just wants answers.”
COVID-19 vaccines are in short supply. Every dose is precious. So we have to ensure that every one of the shots is administered wisely and equitably.
As politicians posture and bicker about vaccine procurement and distribution, average folks just want an idea of when they will be able to get their shot of hope.
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Elderly Canadians in institutional settings such as nursing homes and front-line health workers in direct contact with COVID-19 patients are at the front of the line. There’s little debate in this country about those priorities.
Then we need to vaccinate people in high-risk settings such as group homes, prisons and remote Indigenous communities. These choices need to be based on science, not on the kind of moral judgments and political opportunism that Conservative Party Leader Erin O’Toole demonstrated in a recent tweet.
As more vaccines become available, we need to fan out into the community and target elders such as Mr. Doddy (remember, even the majority of 100-year-olds live on their own – not in long-term care facilities), as well as community health workers (such as his personal support workers).
We can’t neglect people living with disabilities, who are too often ignored in these triage discussions, and we can’t forget about essential workers such as grocery store clerks, food and hospitality workers and teachers.
After that, though, it gets a little murky – and more difficult to prioritize. Sometimes we might well be in coin-flip territory.
Demand is going to outstrip supply for the foreseeable future – most of us will be waiting months for a vaccine.
But that’s okay. Queuing for health care is basically a national sport.
Not everybody can be at the front of the line, but those who are need to be those most in need; those who will benefit most.
When stories emerge of non-front-line hospital staff cutting ahead of high-risk individuals such as veterans and people with disabilities, it undermines the we’re-all-in-this-together approach that is required.
Just because we have a hospital-centric health system doesn’t mean all hospital staff should have first dibs. There are many in the community who are more vulnerable, beginning with those experiencing homelessness.
Cronyism can’t be tolerated and neither can favouritism (is the National Hockey League listening?).
The ethics and politics of the vaccine rollout are one thing – the logistics are even more complex. Jasmine Mah, a web-content developer for Omni Calculator, has developed an online tool that lets you figure out where you are in the vaccine queue, but the calculations are crude. For example, if you’re a 60-year-old non-essential worker, there are somewhere between 12.2 million and 22.4 million people ahead of you in the queue, and you can expect a shot sometime between July and September. That’s because there are many unknowns; when the supply of vaccines will arrive remains uncertain, and the order in which people are vaccinated needs to be refined.
One of the biggest challenges Canada faces will be how it informs people when it’s their turn for a shot. If we had decent electronic health records, this would be relatively easy. But who keeps track of where 90-year-olds live? And how do you contact them for an appointment?
In the United States, where the vaccine supply is far more plentiful, people are being asked to register online or to travel to central locations such as convention centres. That approach favours those with connections (and not just to the internet) and mobility. Unsurprisingly, the rollout has been chaotic.
As always, the most important tool we have in the pandemic is communication. As we move to vaccinate the population as quickly as possible, transparency becomes more important than ever.
We need to keep the public informed – not just about what happened yesterday (warts and all), but what is supposed to happen next.
There are a lot of moving parts and a lot of conflicting demands in a mass vaccination campaign for 37 million people.
Nobody expects perfection. But decisions around who gets vaccinated next need, above all, to be fair – and also perceived to be so.
The initial COVID-19 vaccinations in Canada and around the world raise questions about how people react to the shot, how pregnant women should approach it and how far away herd immunity may be. Globe health reporter Kelly Grant and science reporter Ivan Semeniuk discuss the answers.
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André Picard