The COVID-19 pandemic

[danbrotherston]

The Tuskegee incident is only the most extreme example--and an easy one to evoke, but bias in medicine continues to this day. Even John Oliver did a (US focused) piece on it.

https://www.youtube.com/watch?v=TATSAHJK...eekTonight

Yes, I know that incident isn’t an isolated one. I’m thinking right now of Joyce Echaquan, who died in hospital but left a recording of caregivers making fun of and insulting her. A true hero, who brought into the light truly reprehensible behaviour. Will it lead to the required changes? I don’t know.

But that being said, vaccines are obviously being given out to all; Black or Indigenous (or whatever) populations are not being singled out to take the vaccines first so we can see what happens, and then make corrections before giving them to the privileged white population. At this point, with many millions of doses having been administered and an insignificant number of adverse reactions, continued belief that the vaccines are some sort of plot is absurd, no matter one’s cultural background. And I believe that people of all cultures are capable of recognizing this.

In an employment situation, where I’m suggesting many employees should be required to be vaccinated, this would be all employees: so if one person is somewhat hesitant, they might see their colleague from a different ancestry having their shot too, which should help them to realize that it is not a racist plot.

I'm definitely not arguing against employment requirements. Ironically, the vaccine deployment has been rather biased. Although I'll give some credit there have been attempts to overcome that bias, the best example is the targeted vaccination of northern communities. Some projects that have helped reduce bias have simply been targeted at hotspots, which shows how the disease is also affecting people inequally. But the fact that I was able to get the vaccine at a conveniently located clinic but many hot spot locations had no pharmacies or clinics offering the vaccine at the time, and instead people in those communities had to line up and wait hours for a chance at a vaccine at a popup clinic is really unacceptable to my mind.

It's unclear to me how much this has affected vaccine update...I think the efforts to promote it in these areas has more than overcome the limitations, but it highlights a third way in which certain groups may be less likely to get vaccinated, and that is access--people who lack the flexible working hours that I have may not be able to spend the time to wait in line at a popup clinic--and I didn't even have to do so, how unfair is that.

As for "all cultures are capable of recognizing this"...I certainly believe that all people of all cultures given the same information would come to similar conclusions. But that's an assumption that is just not true... we (the people in this forum) are vastly more well informed than the average person. Leaving aside the fact that we have the free time to spend on this topic and the education (in whatever form) to understand the details, we have the interest and inclination. Not all people do, and it is a consistent blindspot even for myself in believing that everyone else can be expected to be informed about these things (and other topics for that matter).

Fortunately we have a smaller problem than the Americans who have a multi-billion dollar industry dedicated to missinforming and misleading a certain demographic in their society, but that is a long way away from everyone being equally informed.

I do agree though, that seeing one's colleagues vaccinated would absolutely be beneficial.

[ijmorlan]

It's unclear to me how much this has affected vaccine update...I think the efforts to promote it in these areas has more than overcome the limitations, but it highlights a third way in which certain groups may be less likely to get vaccinated, and that is access--people who lack the flexible working hours that I have may not be able to spend the time to wait in line at a popup clinic--and I didn't even have to do so, how unfair is that.

Thanks, lots of good points.

I totally agree we really should start by making sure everybody even has easy access. For me, driving out to the Boardwalk was annoying (because I don’t like the Boardwalk) but not actually even rising to the level of inconvenient. For another, getting way out there could be a significant inconvenience. Bus service isn’t too bad (although not great, honestly; I think the actual clinic might be pretty far from the bus stop) but depending on how busy a person is with kids and a low-paying, long-hours job, even that might not be particularly easy to fit into the schedule.

[plam]

I totally agree we really should start by making sure everybody even has easy access. For me, driving out to the Boardwalk was annoying (because I don’t like the Boardwalk) but not actually even rising to the level of inconvenient. For another, getting way out there could be a significant inconvenience. Bus service isn’t too bad (although not great, honestly; I think the actual clinic might be pretty far from the bus stop) but depending on how busy a person is with kids and a low-paying, long-hours job, even that might not be particularly easy to fit into the schedule.

My friend in Seattle says that vaccines where he is have been extremely accessible ("easier than voting") with driving-you-to-the-vaccine service etc. We certainly do not have that in Ontario and I hope that comes.

[tomh009]

I totally agree we really should start by making sure everybody even has easy access. For me, driving out to the Boardwalk was annoying (because I don’t like the Boardwalk) but not actually even rising to the level of inconvenient. For another, getting way out there could be a significant inconvenience. Bus service isn’t too bad (although not great, honestly; I think the actual clinic might be pretty far from the bus stop) but depending on how busy a person is with kids and a low-paying, long-hours job, even that might not be particularly easy to fit into the schedule.

My friend in Seattle says that vaccines where he is have been extremely accessible ("easier than voting") with driving-you-to-the-vaccine service etc. We certainly do not have that in Ontario and I hope that comes.

Many states are spending a lot of money to make vaccination easier and to provide incentives, to get the vaccinations done. Washington State is one of the better ones and they are still a little bit ahead of Ontario (54.5% vs about 52%) but the accessibility actions have still not got them anywhere close to herd immunity.

[danbrotherston]

I totally agree we really should start by making sure everybody even has easy access. For me, driving out to the Boardwalk was annoying (because I don’t like the Boardwalk) but not actually even rising to the level of inconvenient. For another, getting way out there could be a significant inconvenience. Bus service isn’t too bad (although not great, honestly; I think the actual clinic might be pretty far from the bus stop) but depending on how busy a person is with kids and a low-paying, long-hours job, even that might not be particularly easy to fit into the schedule.

My friend in Seattle says that vaccines where he is have been extremely accessible ("easier than voting") with driving-you-to-the-vaccine service etc. We certainly do not have that in Ontario and I hope that comes.

Given the state of the US democracy, "easier than voting" doesn't mean quite as much there as it does here.

Quite frankly, the whole vaccine rollout has been terrible here.

Right from the beginning...and by beginning I mean last Fall last year (read: September) when it became clear there would be vaccines available in the near term and our government sat on it's ass for five months and did shit all to prepare.

We should have all been pre-registered for vaccination and knowing where clinics were going to be before the first vaccines were approved.

[tomh009]

10-day averages for key regions in Ontario, plus the weekly trend as of 2021-05-25 (posting this every two days).

Region	Cases today	per 100K	10-day average	per 100K	Weekly trend
Peel	231	16.7	410	29.7	-34%
Hamilton	43	7.4	98	16.9	-41%
Toronto	325	11.1	485	16.6	-33%
Durham	60	9.3	103	15.9	-27%
York	77	6.9	143	12.9	-30%
Middlesex-London	9	2.2	48	11.7	-5%
Halton	38	6.9	63	11.4	-33%
Brant	7	5.1	15	10.9	-40%
Niagara	40	8.9	47	10.5	-37%
Windsor-Essex	17	4.4	37	9.5	-16%
Wellington-Dufferin-Guelph	15	5.5	24	8.8	+12%
Waterloo	17	2.8	54	8.7	-22%
Simcoe-Muskoka	20	3.7	41	7.6	-31%
Ottawa	48	4.8	75	7.6	-19%
Huron Perth		.0	6	5.8	-7%
Southwestern Ontario	5	2.5	10	5.2	-42%
Lambton		.0	7	5.1	-21%
Eastern Ontario		.0	9	4.4	-52%
Kingston Frontenac		.0	6	2.8	-56%
Northwestern	1	1.1	2	2.6	+10%
Leeds, Grenville & Lanark	12	7.1	4	2.4	+99%
Chatham-Kent		.0	2	2.1	-81%
Ontario total					-32%

[tomh009]

MONDAY 2021-05-24

bWaterloo Region reported 39 new cases for today (8.2% of the active cases) and zero more for yesterday for 54; 370 new cases for the week (-22), averaging 10.6% of active cases. 466 active cases, -48 in the last seven days.

Next testing report on Tuesday.

Next vaccination report on Tuesday.

Ontario reported 1,446 new cases today with a seven-day average of 1,775 (-103). 2,072 recoveries and 8 deaths translated to a decrease of 634 active cases and a new total of 20,038. -5,831 active cases for the week and 133 deaths (19 per day). Only 20,151 tests with a positivity rate of 7,18%. The positivity rate is averaging 5.62% for the past seven days, compared to 6.46% for the preceding seven.

687 patients in ICU (-6 today, -92 for the week).

99,108 doses of vaccine administered, with a seven-day average at 141,081. At this pace, the dose count will reach 70% of the provincial population on 2021-06-05 (+0 days).

• 393 cases in Peel: 28.4 per 100K
  
• 45 cases in Hamilton: 7.8 per 100K
  
• 387 cases in Toronto: 13.2 per 100K
  
• 78 cases in Durham: 12.1 per 100K
  
• 97 cases in York: 8.7 per 100K
  
• 40 cases in Middlesex-London: 9.9 per 100K
  
• 47 cases in Halton: 8.6 per 100K
  
• 10 cases in Brant: 7.4 per 100K
  
• 25 cases in Niagara: 5.6 per 100K
  
• 32 cases in Windsor-Essex: 8.2 per 100K
  
• 16 cases in Wellington-Dufferin-Guelph: 5.9 per 100K
  
• 53 cases in Waterloo: 8.6 per 100K (based on provincial reporting)
  
• 32 cases in Simcoe-Muskoka: 5.9 per 100K
  
• 48 cases in Ottawa: 4.8 per 100K
  
• 4 cases in Huron Perth: 4.1 per 100K
  
• 4 cases in Southwestern Ontario: 2.0 per 100K
  
• 4 cases in Lambton: 3.1 per 100K
  
• 5 cases in Eastern Ontario: 2.5 per 100K
  
• 3 cases in Kingston Frontenac: 1.5 per 100K
  
• 3 cases in Northwestern: 3.4 per 100K
  

[tomh009]

TUESDAY 2021-05-25

Waterloo Region reported 30 new cases for today (6.4% of the active cases) and zero more for yesterday for 39; 342 new cases for the week (-28), averaging 9.9% of active cases. 448 active cases, -71 in the last seven days.

Testing activity has dropped further, now an average of only 942 tests per day for the past week, for a positivity rate of 5.19%.

An average of 4,457 doses of vaccine administered over the past days (a busy Friday but a quiet long holiday weekend) with a seven-day average of 4,977. At this pace, the dose count will reach 70% of the regional population on 2021-06-22 (-4 days since Friday). This date is now trailing the provincial one by 16 days (-5 over the past four days).

Ontario reported 1,069 new cases today with a seven-day average of 1,693 (-82). 2,018 recoveries and 33 deaths translated to a decrease of 1,012 active cases and a new total of 19,026 -- about the same as the end of March and the end of January. -5,940 active cases for the week and 149 deaths (21 per day). A new low (since July 2020) of 16,857 tests with a positivity rate of 6.16%. The positivity rate is averaging 5.49% for the past seven days, compared to 6.41% for the preceding seven.

692 patients in ICU (+5 today, -72 for the week).

86,927 doses of vaccine administered, with a seven-day average at 137,924. At this pace, the dose count will reach 70% of the provincial population on 2021-06-05 (+1 day).

• 231 cases in Peel: 16.7 per 100K
  
• 325 cases in Toronto: 11.1 per 100K
  
• 60 cases in Durham: 9.3 per 100K
  
• 40 cases in Niagara: 8.9 per 100K
  
• 43 cases in Hamilton: 7.4 per 100K
  
• 12 cases in Leeds, Grenville & Lanark: 7.1 per 100K
  
• 77 cases in York: 6.9 per 100K
  
• 38 cases in Halton: 6.9 per 100K
  
• 15 cases in Wellington-Dufferin-Guelph: 5.5 per 100K
  
• 7 cases in Brant: 5.1 per 100K
  
• 48 cases in Ottawa: 4.8 per 100K
  
• 17 cases in Windsor-Essex: 4.4 per 100K
  
• 20 cases in Simcoe-Muskoka: 3.7 per 100K
  
• 17 cases in Waterloo: 2.8 per 100K (based on provincial reporting)
  
• 5 cases in Southwestern Ontario: 2.5 per 100K
  
• 9 cases in Middlesex-London: 2.2 per 100K
  

[jamincan]

I was speaking to a lady in my building the other day and I found it really illuminating. Discourse online tends to paint people as either science-based, pro-public health, and eager to get vaccinated, or anti-vaxxer, anti-masker nuts. My conversation with her came from me mentioning in passing that I was happy as I had just gotten vaccinated the previous day, and she followed that expressing uncertainty and hesitation about the vaccination itself. Notably, she was happy that I got the vaccine, she is not at all anti-mask, and not at all anti-public health, and even said she probably would get the vaccine eventually, she just was hesitant and unsure and clearly conflicted. I didn't try to offer any medical advice as I definitely don't feel qualified, but I did mention how surprisingly smooth and hassle-free the whole experience was for me and how it felt good to feel like I was contributing to getting us closer to being out of all these restrictions. She specifically said the latter was actually a strong motivation for her to get vaccinated.

I suspect there are actually quite a lot of people like her. When I went and got vaccinated, there were a lot of people my age, but there were still people getting vaccinated who were clearly eligible months ago. I was prepared to get vaccinated the day that Health Canada approved the Pfizer vaccine, but other people are going to take longer to come round. I do think one thing that has been lost in the communication to the public is that while we are individually vaccinated and individually benefit, it is also an act that benefits the whole community. It was something I constantly reminded myself as someone who was farther to the back of the queue of eligible people - that even though I wasn't getting my shot just yet, I'm also benefitting from every single other person getting a shot. The corollary is that by getting the shot, I'm benefitting the people around me too. Often times, more outward-focused community-minded motivations like that can resonate with some people/cultures more than the more individual-focused ones.

[danbrotherston]

I think there has been a strong focus on the community aspects of it, certainly more than in the US...although that's clearly culturally driven. You are right that there are a lot of people in the "hesitant crowd" that absolutely could be helped with better communication.

That being said, those "hesitant" folks are not marching in the streets and harassing children like lunatics. But those lunatics are ALSO spreading social media miss-information that does influence the hesitant folks.

Ultimately, we have many problems...some are more solvable than others...and fortunately vastly more people fit into the "hesitant" category than the lunatic category.

[tomh009]

A small vaccination tidbit: a little under 20% of the doses yesterday were second doses. The percentage is increasing but the focus is still on getting people the initial doses.

[taylortbb]

A small vaccination tidbit: a little under 20% of the doses yesterday were second doses. The percentage is increasing but the focus is still on getting people the initial doses.

I'm surprised it's that high. I still haven't been contacted by public health to book, I don't think they've reached under 40s yet. So it's certainly not demand driven, and the criteria for second doses are pretty narrow.

I'm not still waiting, I got my shot at a pharmacy. But given I signed up early morning the day pre-registration opened wide and there's no way to cancel, I'm still using my invitation to book as a benchmark.

[tomh009]

A small vaccination tidbit: a little under 20% of the doses yesterday were second doses. The percentage is increasing but the focus is still on getting people the initial doses.

I'm surprised it's that high. I still haven't been contacted by public health to book, I don't think they've reached under 40s yet. So it's certainly not demand driven, and the criteria for second doses are pretty narrow.

I'm not still waiting, I got my shot at a pharmacy. But given I signed up early morning the day pre-registration opened wide and there's no way to cancel, I'm still using my invitation to book as a benchmark.

I'm pretty sure the early second doses are being driven by the inventory of AZ vaccine that is nearing its expiration date. And at the moment they are no longer using AZ for first doses.

[jeffster]

My friend in Seattle says that vaccines where he is have been extremely accessible ("easier than voting") with driving-you-to-the-vaccine service etc. We certainly do not have that in Ontario and I hope that comes.

Many states are spending a lot of money to make vaccination easier and to provide incentives, to get the vaccinations done. Washington State is one of the better ones and they are still a little bit ahead of Ontario (54.5% vs about 52%) but the accessibility actions have still not got them anywhere close to herd immunity.

I would agree that the particular location of this vaccine clinic isn’t ideal for many. It’s not centrally located, and for those with low income, it would be quite a day trip if coming from another part of town. I wonder if they could have chosen some pop-up clinics.

[taylortbb]

I'm pretty sure the early second doses are being driven by the inventory of AZ vaccine that is nearing its expiration date. And at the moment they are no longer using AZ for first doses.

Yes, that makes sense, you're right. I totally forgot about the expiring AZ doses.