The ideal of establishing six mass-vaccination centres throughout the Haliburton Kawartha Pine Ridge District Health Unit is half-realized with three confirmed locations – the Cobourg Community Centre, the Campbellford firehall and the Lindsay Exhibition Centre.
Medical Officer of Health Dr. Ian Gemmill announced the news in this week's media scrum, reiterating his hope that each of the region's three municipalities establish two locations with the ideal that nobody should have to drive longer than a half-hour to reach one. Northumberland County's two locations are set, and the Lindsay site is one of the two in the City of Kawartha Lakes. In the County of Haliburton, he added, they are looking at sites in Minden, Haliburton and Wilberforce.
“It will be a different process with different people at different steps of planning in different places,” Dr. Gemmill said.
Debate at Cobourg council Monday night before they approved the memorandum of understanding to allow the clinic to be set up at the CCC from March 15 through Sept. 30 brought out details of what is needed for a vaccination site – secure segregation from the usual business of the site, mechanisms for crowd control, some set-up to allow greeters and screeners to process arrivals, a safe place to wait and a safe place to be monitored for 15 minutes after the vaccination. They are expecting to begin actual vaccinations there Tuesday.
Dr. Gemmill is pleased with the count of only a handful of cases a day, far lower than it was a month ago. But he repeated the advice he gives every week – this is no time to let up, as 95% of our population is still susceptible. And while the incidence of variants of concern is growing only slowly in the local region, he is hearing that up to 40% of cases in Toronto are VOCs.
“Please don't relax your preventive measures yet,” he urged.
“They will have to be in place for many more weeks, maybe even over the summer.”
The news of Canada approving two new vaccines is exciting, he said – but as yet, neither AstraZeneca nor Johnson & Johnson are coming to this area. HKPR vaccinations for now will be the two mRNA vaccines, Pfizer and Moderna, which both require two doses.
Though long-term-care home residents in the region do have both doses because of their vulnerability, the province has determined that hereafter first doses will be completely rolled out to everyone eligible to get them before vaccine will be allocated to second doses.
“I agree fully with this strategy to get more vaccine to more people as quickly as we can, because that will provide more community-based protection – herd immunity – and prevent the virus being so easily transmitted,” Dr. Gemmill stated.
Based on the rate they are receiving vaccines, his estimate is that the gamut of first doses will take 36 weeks to roll out.
“Even with one dose, we are seeing some reasonable protection and, while it won't be 100% or even 95%, these are great vaccines and we may be surprised how good the protection is, even after one dose,” Dr. Gemmill said.
And even among a population with one dose, he said, the virus will be asking, “Who can I infect? There's nobody left.”
The HKPR region has seen almost 14,000 doses administered, he estimated. And not only is he aware of no wastage of this precious resource, he has heard such stories as the use of pharmacy technicians at Northumberland Hills Hospital to ensure that six doses can be extracted from a Pfizer vial.
“That is not happening everywhere,” he stated.
“I think we are getting more value than some other places.”
Following the sweep of long-term-care homes, vaccines in the HKPR region are going to retirement homes, the Alderville First Nation community and the highest-priority health-care workers.
Vaccinations of 80-plus-year-olds will begin next week, and he had some specifics to offer about how this will happen in Northumberland County. Eligible residents who have family physicians will get calls from a corps of volunteers to set up appointments for a shot at the CCC, where the set-up will be administered by volunteers and care givers from Northumberland Hills Hospital and Family Health Teams.
Eligible residents who do not have a family physician can get appointments through the provincial on-line and telephone lines set up for that purpose, with the OHIP number they provide offering proof of age.
“They are going to have hundreds of operators standing by to assist people with appointments,” he said.
“Anyone born in 1941 or earlier will be eligible at this time to receive the vaccine.”
A similar system is set up at the Campbellford firehall he added.
Then, in due course, succeeding age groups will have their turn. But while they're waiting, he said, “nobody out there should be calling their family doctor and saying, 'where's my vaccine,' because it will flood their lines.
“And it's not their offices who are calling. There will be a community group working with our family docs to get in contact and make the appointment for these folks.”
These larger centres don't preclude drive-through clinics, which he believes the Campbellford site may try, or pop-up clinics that set up for a few days or a week to augment the vaccination roll-out. This kind of initiative may come along later, he said.
“Right now, we want fixed sites going like a well-oiled machine.”
Dr. Gemmill's understanding is that the region can expect to get about 5,000 doses per week.
“There can be reallocations, there can be supplies that don't arrive for whatever reason. But that is what we have been earmarked for,” he said.
“We will get through the vaccines and, if we are using it up as fast as we can get it, I will ask for more.”
Dr. Gemmill was asked to account for a flu season whose numbers he termed “ridiculously low – I have never seen it so low.”
He cited several possibilities, such as the natural caution people are exercising in the face of the coronavirus and the fact that more people took advantage of the opportunity to get their flu shots than usual.
And he had a theory of his own.
“My observation has been, over the years, when a new virus comes along, other viruses become quiescent for a little while,” he said.
The H1N1 outbreak in 2009, for example, made the flu almost disappear. However, it came back the following year with a vengeance, which he fears is a possibility for next fall.
He closed the session with his own beliefs on what a COVID future looks like.
“I think it's not going to be going away,” he said.
“I think Coronavirus will probably be around unless we can figure out a way to eradicate the virus.”
One important unknown (which should soon become apparent) is how long protection from the vaccine may last - “and it may not be very long.”
Some things only require one shot like hepatitis. Some require annual inoculations like influenza. The frequency of any subsequent COVID shot may be annual, may be every two years, may be every five.
Or we as a population may build up sufficient residual immunity that subsequent inoculations are required only in such cases as the aged and those with special health concerns.