Ruminations

Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Tuesday, May 04, 2021

In Canada : Half a Cure

"We are scared. We are worried about dying. We would like to have as much protection against it [COVID] as possible."
"If we are not fully protected and redeployed to places that primarily treat COVID patients, we will start dropping like flies."
"If we want nurses to take care of these patients, we need to make sure they are protected."
"[Government would find it easier to persuade health-care workers out of retirement to help] if they knew the government would take care of them; [instead many are leaving the profession]."
"We're struggling. We need help. We need support way more than just the thank you, you are heroes."
Unidentified Ontario nurse
ICU
Inside Ontario's hard-hit hospitals, staff are stretched thin, with experts warning that the third wave could cause ICUs to fill up with more patients than there are doctors and critical care nurses to treat them.
 
A group of nurses who practice in Ottawa feel themselves to be more vulnerable than ever to contracting COVID-19 and this thought absolutely terrifies them. They refuse to be personally identified for fear of official/unofficial retribution. Though they are anxious to protect their jobs, they are also hopeful that health and government officials will listen to their pleading for a second dose of the COVID vaccine on an urgent basis. Simply put, the high numbers of seriously ill COVID-19 patients being hospitalized is placing health-care workers at additional high risk themselves.

In one of the hardest-hit COVID regions of Ontario last week, a nurse died of COVID-19. Nurses everywhere in Ontario visualize a similar fate for themselves. In recent weeks record numbers of COVID-19 patients have converged on hospitals with staff being redeployed while other programs and services have been placed on pause, with the focus now on dealing with the influx of the third wave. This leaves nurses faced with the prospect of more exposure in working directly with COVID-19 patients.

The federal government in its great wisdom accepted the suggestion from its ranking health committee on COVID-19 that it would be advantageous to put off administering a second shot in the greater interests of seeing that a larger number of Canadians receive their first dose. The period between doses has been officially lengthened to 16 weeks from the original pharmaceutical manufacturers' recommended two to three weeks between the two doses on the theory that the initial dose would confer a large degree of immunity and people could wait longer for their second dose.

This, in an effort to balance too few vaccines being received at a time when infections have soared, and with them a growing cohort infected with variants 'of concern'. The United Kingdom, suffering a large third wave of infections led by the UK variant, has also taken to administering the initial dose and putting off the second dose for 12 weeks, in the interests of inoculating a larger segment of the population by withholding the second dose. 

A study in the United States tracked 91,134 patients of the Houston Methodist Hospital system, about 4.5 percent of whom were partially immunized and 25.4 percent fully vaccinated. Among them were 225 deaths from COVID in the group, 97.3 percent were unvaccinated, 2.2 percent partially immunized, and one percent (0.004 percent died following full immunization. Saad B.Omer, director of the Yale Institute for Global Health, the study's senior author, began the research with a "neutral" view of benefit endowed with two doses versus a single dose. The results of the study convinced him of the benefits of a second dose preferentially.
"One dose in terms of all of our measurable immune parameters of [the Pfizer vaccine] really does look very, very feeble and all the more so against variants. And yet whatever the level of immunity that it's induced, it's certainly been enough to have had some impact."
"But it's really very, very weak compared to two doses."
Professor Danny Altmann, study co-author
According to Cole Pinnow, CEO of Pfizer Canada, Canada's decision to allow a 16-week spread between first and second doses, instead of the recommended three weeks, is not based on science. "All the clinical data that we generated, all the science that has established the expectations for the efficiency and effectiveness of our products is rooted in science and the science supports a 21-day dosing schedule for our product -- plus or minus a little bit of a variance. I think [it] is as little as 19 days and up to 42 days. So we're disappointed that Canada has chosen to differ from the vast majority of the world that is adhering to the 21 day dose schedule, but we also recognize that legally it's their decision to make."
Hospital worker
 
The actual lag in vaccine arrivals on contract to the various vaccine producers has resulted from the Liberal government's decision early on in the game of preparations for a huge national vaccination effort to control the SARS-CoV-2 virus causing COVID-19, to partner with a Chinese biomedical firm, CanSino, to co-produce a vaccine structured on a base given CanSino by the National Research Council's laboratories in Ottawa. That agreement fell through when Beijing refused to allow vaccine from China to be sent to Canada.

Which gave the federal government under Prime Minister Justin Trudeau a late start in ordering vaccines from reputable pharmaceutical producers, hence a shortage of needed vaccines in Canada when we were back-of-the-line, so to speak, and the perceived need to modify the vaccine therapy from three weeks to 16 to have doses stretch further faster, vaccinating a greater number of people with only one dose until the lapse of four months between doses.
"The second dose of mRNA vaccines [Pfizer and Moderna] induces a level of virus neutralizing antobodies about ten-fold greater than the first dose."
"Also, the second dose induces cellular immunity, which predicts not only longer protection, but better protection against variant strains."
Dr.Paul Offit, professor, University of Pennsylvania, member U.S.Food and Drug Administration vaccine advisory panel
Vaccine rollout
Employees are vaccinated at a COVID-19 vaccination clinic at CAE headquarters in Montreal, on Monday, April 26, 2021. A provincial program to provide vaccinations at large businesses began today at the Montreal headquarters of the flight simulation technology manufacturer. THE CANADIAN PRESS/Paul Chiasson

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