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‘We need to be flexible,’ warns top Ontario science table doctor as hot spot vaccine ramp-up comes to an end


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‘We need to be flexible,’ warns top Ontario science table doctor as hot spot vaccine ramp-up comes to an end

A top doctor with Ontario’s COVID-19 science advisory table says public health units will have to be nimble to meet continued high demand for vaccines in hot spots as the province’s program to allocate 50 per cent of all shots to these areas comes to an end.

Dr. Peter Juni, scientific director of the science table, is stressing the need for flexibility in the coming weeks as vaccine allocation in Ontario’s 114 hot spots and the rest of the province reverts to per-capita based distribution this week.

“A fixed allocation of vaccines is not really reflecting the changing challenges of vaccine distribution over time. What you need in each hot spot is to understand what the demand is for the current week and be able to increase over and above current allocations if necessary,” Juni said.

“In the highest-risk neighbourhoods, we haven’t yet reached a high enough percentage of adults who have been vaccinated. So we need to keep trying and this will require us to be more flexible with the allocation during the next few weeks.”

At the beginning of May, the province bumped up vaccine allocation in Ontario’s highest-risk neighbourhoods to 50 per cent of all new doses for two weeks in an effort to reduce transmission, hospitalization rates and deaths. The plan, which comes to an end this weekend, was criticized for not following a recommendation by the science table to divert half of all doses to the 74 hardest-hit neighbourhoods for a month.

The science table calculated that the province’s two-week plan could result in 75 per cent of eligible adults living in hot spots getting vaccinated, depending on supply and logistics.

According to Juni’s projections, based on data from ICES (formerly the Institute for Clinical Evaluative Sciences), close to 60 per cent of people 18 years old and over will have been vaccinated in Ontario’s 114 hot spots by Monday, while the rate in the remaining low-risk areas will be about 50 per cent.

With the end of the program, public health units containing many of the hardest-hit areas will see their vaccine allocation dramatically reduced. As the Star’s David Rider reported on Friday, Toronto Public Health will see its allocation drop to 179,020 doses on May 17, down from 337,170 the week prior, while Peel Region will receive 87,790 doses next week, down from 149,760 for the week of May 10.

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Both regions have positivity rates higher than the provincial average.

“There are certain areas of the province, especially Peel Region and certain parts of Toronto, where the protections that have been put in place by the government — whether it be rapid tests in factories or three days of nominal-paid sick leave — are not going to be enough to keep people safe,” said Dr. Michael Warner, medical director of critical care at Toronto’s Michael Garron Hospital, who argues that the pandemic will last longer in Ontario by reverting back to per-capita distribution now. “The most durable and significant defence that people who live in these areas have will be timely access to vaccination.”

He stressed that non-hot-spot areas would continue to receive their proportional allocations of vaccine if the province continued to allocate 50 per cent of all doses to hot spots, a strategy that would allow for the protection of the most vulnerable populations, such as essential workers and their families. Warner added that hospitals in Scarborough, Peel and north Etobicoke admitted 17 COVID-19 patients on Friday night.

“If we’re going to say that it’s time to make sure that everybody gets their proportional allocation of vaccines based on population, then I would say, why are helicopters flying to Kingston with patients from the GTA? When that ends, then we can talk about it’s time to be fair,” Warner said.

In the last four days in Ontario, ICU admissions due to COVID-19 have slowly been creeping up, from 773 on Wednesday to 784 on Saturday.

Dr. Isaac Bogoch, a member of the province’s COVID-19 Vaccine Distribution Task Force an infectious diseases physician at UHN, said the switch back to per-capita distribution “doesn’t mean there isn’t a focus on equity anymore.”

He stressed that Canada is scheduled to receive over a million more doses than expected this week and that public health units can choose to allocate more vaccines to certain areas if they wish.

“Even though the proportion has now changed, the absolute number of vaccines, while it will go down for sure a little bit, it will also rise back up as more vaccines come into the country,” he said. “Which means the number of vaccines administered, hot spot or not, is going to continue to grow with time as well.”

Kenyon Wallace is a Toronto-based investigative reporter for the Star. Follow him on Twitter: @KenyonWallace or reach him via email: [email protected]

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