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Apr. 16, 2021 | Friday
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Dr. Brown: We need to get COVID vaccine into community now
Dr. William Brown.

Dr. William Brown is a professor of neurology at McMaster University and co-founder of the Infohealth series at the Niagara-on-the-Lake Public Library.  

You don’t have to be an expert in public health to figure out what’s been going on in this pandemic.

One look at the trajectories of the numbers of new COVID-19 cases and deaths beginning last spring and running through to the present in the U.K., U.S. and Canada reveals what happened.

The initial surge last spring rapidly peaked before steadily falling in the face of now very familiar and proven effective public health measures such as wearing masks, social distancing, avoiding large groups and imposed shutdowns of varying severity. By summer the numbers of new cases and deaths were much lower – simmering but manageable.

We were warned in the summer to expect a fall surge and, sure enough, it began in September and coincided with the reopening of schools, colleges and universities, and large social gatherings.

Still, it was manageable – until mid- to late fall with Thanksgivings north and, especially, south of the border, the fallout from which merged seamlessly into Christmas and New Year’s seasons and the related festivities.

The latter, together with the emergence of a far more transmissible virus originating in the U.K., drove the current enormous spike in cases and deaths – more than doubling, even tripling spring’s numbers. It got us to where we are now: in the middle of an uncontrolled pandemic.

For which disaster there’s plenty of blame to go around. With few exceptions governments from most countries including Canada have been too cautious and too late in imposing lockdowns – perhaps because they feared that locking down before Christmas would upset business interests already reeling from months of the pandemic and a public emboldened by news of highly effective vaccines, tired of a year’s worth of pandemic and looking forward to a festive season. In that sense, we were all at fault.

The price tag has been high, never more so than in long-term care facilities where residents were sitting ducks for the virus because of their age, comorbid conditions, the close proximity of others and the comings and goings of staff, despite testing.

That’s precisely what happened here in Niagara and in many countries around the world. In the NOTL long-term care facility where my wife resides, the number of cases testing positive grew from an initial few staff members to involve more staff and, as of Jan. 19, a total of more than 90 residents and staff had tested positive, though most of them are asymptomatic so far. This all happened in less than two weeks.

Fortunately, all residents of the home, except those who tested positive beforehand, were vaccinated a few days ago. It would be easy to blame individual facilities but that would be a mistake.

 The home where my wife resides is well-managed and tries its best to keep families up to date and care for their charges. But in the face of so many community cases, most of them asymptomatic and probably a result of holiday get-togethers, the surprise is not that outbreaks like this occur but that so many facilities managed to keep the virus out for so long – a year and counting.

Probably, the most important lesson learned was that daily screening questions and taking temperatures, coupled with weekly testing wasn’t enough to block the occasional "leaker" getting through and infecting staff and residents alike.

We clearly need daily, on-site, before work, rapid testing and reporting using one of the newly developed methods. Even though many of these tests aren’t as sensitive and/or as specific as the gold standard PCR test we’re so used to, they are good enough and a lot better when repeated every workday.

These days this pandemic is out of control throughout much of the western world, but the hope is that with the holidays now over and lockdowns in place, the tide will turn and February will see falling case numbers and deaths.

But to really put a stop to the virus we need to vaccinate at least 70 per cent of the population to establish a barrier to the spread of the virus – the herd effect we’ve heard so much about. That means an all-hands-on-deck approach to getting as many people vaccinated as soon as possible, beginning with the most vulnerable – those in long-term care facilities, nursing homes, over 65 years of age and those with comorbid conditions.

We need to be imaginative and creative in whom we recruit to help and where. There are plenty of retired nurses and a few doctors in the region who could help out and, as NOTL pharmacist Sean Simpson pointed out in last week’s Lake Report, local pharmacists would no doubt lend helping hands and perhaps the lead.

As I write this piece, Disneyland in California has been turned into a giant vaccination centre for thousands a day and for the same purpose, the British marshalled Salisbury and several other cathedrals. The symbolism for the latter is powerful, for in a modern age, those who serve and those who receive do so under a vaulted ceiling from another age, now in this age finding new purpose.

We could do the same with our churches and public spaces such as the NOTL Community Centre. That’s the kind of thinking and doing we need to get the job done of protecting our community and, most importantly, bind the whole community together to a common purpose. This is not a time for whining and blaming – this is a time for reimagining how we get this done as a community and do it.

Adding urgency to the matter is what those who track the genome of this virus keep warning us about – it's a very real possibility that a much nastier version of the virus might emerge somewhere in the world, one the vaccine creators haven’t seen yet, forcing them and us to scramble all over again.

That’s why it’s so important to stop this virus everywhere – and soon. This is a worldwide pandemic and demands a worldwide solution, not just a western, Chinese, Indian, Russian or other country solution.

It is a world problem, which, like climate change, knows no borders, cultures, languages, colour or beliefs. What we do or fail to do, will be the measure of humankind.

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