Friday, April 02, 2021

We need an industry-targeted vaccination push, and we need it yesterday

As Ontario heads back into what its government persists in calling a "lockdown" or "shutdown" or "emergency brake" (insert your favourite phrase here),even though those definitions have been substantially watered down in recent weeks, leading public health experts continue to criticize the Conservative governmemt's handling of the pandemic, and their ignoring of health experts' recommendations. We are in an out-of-control third wave, and drastic action is needed. 

But Doug Ford's watery "tough new measures" are not new at all. Toronto and Peel - which is where the worst numbers are, and have always been - have supposedly been locked down for weeks now, and the case numbers are still going up. How is more of the same going to make a difference? The usual inconsistencies continue: relatively low-risk activities like outside dining are being stopped, while relatively high-risk ones like indoor church services are still allowed. A group of 153 ICU doctors hace presented Ford with an open letter explaining just why his response is inadequate.

However, finally, I do believe that the right questions are being asked in a much more public way (e.g. on television news programs), in particular the idea of targeting the vaccination effort to the areas of most community spread, both geographically and industry-wise. 

The main effort so far has been targeted at age groups, in an attempt to vaccinate those most at risk of death or serious illness, which is a reasonable approach at the start. But now we have reached the stage where specific industries, racial groups and geographic areas need to be the focus, and health and infectious diseases experts are becoming increasingly vocal about it.

The general label that covers virtually all of those primary targets is "essential workers", whether this is healthcare workers, supermarket staff, or workers in factories, food production facilities, warehouses, distribution centres, or any number of other jobs that come under the general heading of "essential". For months now, it has been clear that essential workers are the largest single vector of new cases and viral transmission, and there is a huge disconnect between the sectors of society that are most at risk of contracting the virus (and psssing it on to others) and those who are being vaccinated.

COVID-19 cases and deaths in areas with most essential workers (blue line)

Unless and until we start vaccinating essential workers in a big way - and soon - any number of lockdowns, any analysis of whether hairdressers should be open or closed, or whether restaurants should be allowed to open their patios, is moot and all but useless.

And I don't mean just a grudging acceptance that essential workers should be allowed to compete against seniors for available doses. I mean an aggressive policy of actively encouraging vaccination in these sectors, including taking the vaccines to the workplaces, rather than just hoping that some of them will take time off work and travel to a mass vaccination centre. We finally have enough vaccine doses to be able to do this. It has to be a concerted push, and it's pretty clear that we can't rely on employers to do the right thing here. 

It's even more important to push hard because so many essential workers are racialized minorities, and so (for reasons that I still don't fully understand) are much more likely to be vaccine hesitant. We need union involvement, community leader involvement, celebrity involvement, whatever it takes to get as many of these people vaccinated as possible, for their own good and for the good of the country as a whole.

Vaccination coverage by risk areas

Paid sick leave would help too, although I've all but given up hoping for action on that.

All this is now being talked about seriously in a variety of public forums. I can only hope that it is just a matter of time before our governments realize what they need to do, and what they should have been doing for some time now.

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