By Cecilia Nasmith
Acting Medical Officer of Health Dr. Ian Gemmill – whose position was on an interim basis until Dr. Rachel Bocking can begin on the job next Tuesday – gave the last of a series of COVID-19 media scrums last week, a proactive measure he began in the new year to provide the most up-to-date information for maximum dissemination throughout the community.
These sessions have inspired positive local comment for Dr. Gemmill's helpful advice and calming manner, and this was true of the last one – which closed with his prediction that the growing number of variants will pose the next threat.
“If we can get people immunized and keep those at bay until we do, then we are all going to be better off,” he said.
The incidence of variants is growing at a somewhat slower pace than in other areas, Dr. Gemmill noted, “not going up to the same worrisome degree that they are in other parts of Ontario. But things can turn on a dime. It has been happening everywhere, it could happen here as well.”
It's a message Dr. Gemmill has reiterated each week.
“Anything can happen. It just takes a couple of ill-advised events that can lead to a number of people being infected, and then they infect others, and that's how it starts.”
The 57 new cases reported over the last 14 days include very few associated with outbreaks, “because most of the places we were having outbreaks before are immunized, and I am so glad about that. I am so glad the long-term-care homes seem to be safe.”
Of the region's population of 180,000, more than 17,000 have had at least one dose. This is getting close to 10% of the population, Dr. Gemmill noted. And the fact that more than 19,000 doses of vaccine have been administered takes into account long-term-care residents, members of the Indigenous population and others who have had both doses.
Another piece of good news - supplies of vaccine coming in are more than he had originally expected.
Dr. Gemmill always stresses that getting the vaccine does not remove one's duty to maintain the social-distancing, masking, hand-hygiene and other preventive measures so necessary to slowing the spread, simply because there has not until now been the opportunity to observe and track the degree of immunity conferred.
“As nicer weather appears, it's time to go out and enjoy the outside with friends, keeping our distance, and it's time to enjoy the Easter holidays, if it's warm enough, on the back deck,” he said.
“We really think two doses will give us, at some point in the not-too-distant future, the opportunity to really get together. But now is not the time, because we really don't know enough about the effect of one dose.”
Dr. Gemmill thanked the partners who have been operating the Cobourg centre (Northumberland Hills Hospital and the Northumberland Family Health Team) and the Lindsay centre (Ross Memorial Hospital). The health unit is now taking over the Cobourg centre, and the region's remaining four mass-vaccination centres will be opening over the next two weeks.
The doctor took a few minutes to discuss the controversial AstraZeneca vaccine which, to date, has gone only to pharmacies in three large communities as well as some family doctors' offices. Concerns over blood clots that might possibly be associated with this vaccine have caused concern to National Advisory Committee on Immunization, and caused the province to halt its being administered to anyone under 55 years of age.
Dr. Gemmill pointed out that any troublesome symptoms will appear within 20 days of getting an AstraZeneca vaccine. If they haven't appeared by then, they aren't likely to. Similarly, if no symptoms appeared with a first dose, that means a second dose is also likely to be safe.
At any rate, he added, known incidences of blood clots that could be associated with the vaccine are far lower than blood clots known to be associated with COVID-19.
News of Pfizer vaccines being tested on children is good news for everyone, Dr. Gemmill said. So-called herd immunity depends on a certain proportion of the population being vaccinated – and that means population of all ages. Without this protection for children, a far greater proportion (perhaps 80% to 90%) of the remaining population must be vaccinated to achieve this status.
Similar good news is that some 82% of the population aged 80 and over have either been vaccinated or made an appointment for one. The uptake of the 75-plus age group, he added, is “pretty darned good.”
News of concern that has been reported is the steep rise in provincial cases and the associated filling-up of hospital ICUs. Asked if the province should consider a shutdown, Dr. Gemmill shared his opinion that the HKPR region has been yellow for several weeks and that this is the right designation for the area. He added that a more important consideration province-wide is getting people to understand how the virus behaves and then conduct themselves in accordance with the common-sense preventive measures that are common knowledge by now.
“We need to talk to the population and say, 'we are getting enough vaccine. You are going to get some protection, but you have to stay home and put these measures into place until we get the vaccine into your arm. The dose is a great first step, but it doesn't mean necessarily that we have the population based protection we need,'” he stated.
As more pharmacies get vaccine supplies to offer community-based vaccinations, Dr. Gemmill is hopeful that, at some point, three pharmacies will be able to offer this service throughout the region. This will offer people who are not now eligible an opportunity to proceed with their shots.
The HKPR region has been consistent in not uploading appointments into the provincial booking system until there is a committed vaccine for each one. The result is that local people booking appointments may be directed elsewhere. Local residents, for example, have been unable to make Cobourg appointments and have been directed instead to Norwood and Trenton.
Similarly, people from other communities might be given an appointment in the HKPR region. But Dr. Gemmill said that it's not a fact of “their” using up “our” vaccine. The vaccine is for the province to distribute, and it gives HKPR a certain amount in trust for them to distribute through the clinics they set up.
But it's not an ideal system in that it goes against the ideal that we have to minimize travel to minimize the spread. If it were possible, Dr. Gemmill said, he'd like it if nobody had to drive more than 20 to 30 minutes for a shot.
At times, a clinic will close for the day having on hand (for whatever reason) unused vaccine that must be used soon or expire. Dr. Gemmill urged people not to congregate around a site hoping to take advantage of the situation for two reasons. One, congregating is an excellent way to spread the virus. Two, the health unit maintains a waiting list of people who, for whatever reason, should be vaccinated but have not been able to – people under the current age guideline, for example, who have a chronic health concern like a heart condition.
There is information on the health unit website where people who think they should be considered for such a list can submit their names.
Like the flu we are all familiar with, COVID-19 is a virus that likes the winter and early spring. Summer is coming, Dr. Gemmill reminded everyone – and if you think of how different things looked last summer, that wasn't too bad.
His own hope is that this summer sees first and second doses for everyone who wants one by the time autumn eases in, because another winter of pandemic could be quite demoralizing.
Just because summer lies ahead and there is the hope vaccinations offer, Dr. Gemmill said we cannot ease up on the precautions. As a cautionary example, there is the news of the neighbouring Hastings-Prince Edward region that had 32 new cases on a recent day.
“I understand that was associated with inappropriate gatherings,” he said.
“This is exactly what I am saying.
“It's been 13 months now. It's been a long year. But we don't have that much longer to wait. If we can avoid this kind of situation right now, everyone will be better off. Everybody wins if we can keep the faith for another few weeks.”
Manager of Corporate Services Chandra Tremblay said the hope is to resume weekly media scrums at some future point, once Dr. Bocking has settled into the job and had time to become familiar with the local situation.
