Oh Canada! – let us not follow you.

The vaccination program in NZ is due to escalate when it goes into phase 3 – probably in May. The recently released projections on the Covid-19 dashboard (hat-tip: BusinessDesk “How we will get to full vaccination“) show a breakdown of expected vaccination rates by DHB, week and other factors.

It is pretty ambitious logistical operation to vaccinate a whole population with the resources in-country within a few months. There are a lot of potential gotchas. As a comment on the BusinessDesk article comments – it’d be nice to know how many vaccine doses were planned to be in country and when. But there are also issues finding mass vaccination sites. Notifying people in various phases that they should come and get a first jab. Notifying people to get second jabs at an appropriate time.

Just getting enough trained staff or training staff to do the jabs and handle any complications within the period of a few months is going to be a pain. After nearly 45 years, I remember being trained as a army medic on how to administer injections on each other. Such was the trauma, that the memory is still vivid. At least as an 18 year old medic, we didn’t have the thin skins of the elderly to deal with.

But this all has to happen in the midst of a worldwide epidemic. So while this process is going on, the last thing we need is an outbreak. Harder now that we’re opening up to Australia because that will significantly raise the risk level in NZ as it bypasses the quarantine facilities.

To refresh people memories on exactly how fast an outbreak can take hold, just look at the current wave going on in Ontario and in particular Toronto – while the vaccination program is actively running. Less than a month ago there were around 1000 new cases of covid-19 in Ontario. Now their daily rates are well above 4000 in a full-blown outbreak. BBC World reports in “Covid: Canada sounds the alarm as cases overtake US

The rate of coronavirus infections in Canada’s biggest province has reached an all-time high as hospitals warn they are close to being overwhelmed.

A panel of experts say infections in Ontario could increase by 600% by June if public health measures are weak and vaccination rates do not pick up.

Last week, for the first time since the pandemic began, Canada registered more cases per million than the US.

About 22% of Canadians have now received a first vaccine dose.

That compares to 37% in the US.

Ontario is now introducing strict new public measures, including:

  • a six-week stay-at-home order
  • restrictions on non-essential travel, including checkpoints at the borders with the neighbouring provinces of Quebec and Manitoba
  • new powers for police to stop and question people who leave home
  • a halt to non-essential construction

Canadian Prime Minister Justin Trudeau said the federal government would help Toronto, the largest city in the country, which has been hard-hit by the latest surge.

“We’re going to do whatever it takes to help. Discussions are ongoing about extra healthcare providers, and we are ready to step up,” he said on Friday.

Basically the new UK variant B1.1.7 with it faster infection rate managed to cause and exponential growth.

On Friday, Ontario reported 4,812 new cases, its third straight day of setting new records since the pandemic began.

Hospital admissions and the number of patients in intensive care also set records for Ontario: 1,955 and 701, respectively.

The expert panel said the best-case scenario would bring new cases down to about 5,000 a day, but only with considerably more stringent public health measures than the ones now in place.

It would also require a vaccination rate of 300,000 a day – three times the current pace.

Last week the College of Physicians and Surgeons of Ontario warned doctors that they might have to start making decisions about who to admit to intensive care, because units were stretched almost to capacity

I am sure that we will have the usual dimwits (curtain call for Mike Hosking) and even irresponsible National MPs and other carping critics calling for fast opening of borders and faster vaccination regimes. However in the history of pandemics and epidemics, we are getting into the most dangerous stage after the initial spread.

This is when populations get complacent. In history it is when the first wave or two of a pandemic flood through and there is a hiatus of few new cases. Then a variant with a better infection system comes through and demonstrates the number of people still in the population without immunity or with limited immunity to the new variant.

In this case, people get their first shot or even their second, feel that the worst is over, and lower their precautions against spread and infection. But it is likely that people who are vaccinated may still be able to carry and transmit the infection to others – we won’t know that for certain for each vaccine for months or years. Raised levels of infection in the population also increase the probability of even the vaccinated getting infected with a more virulent variant.

Vaccines aren’t silver bullets that guard any particular individual – even if they are vaccinated. They reduce probabilities of infection. What guards the individual in a population is that an infection is capable of gaining a significiant foothold in the population to the point it can produce new variants and an exponential spread.

Basically vaccination is a communal response rather than an individual one. We need to concentrate on how to get that right now in the preliminary phases before we start the phase 3 and 4 process of vaccinating the whole population. That last thing we want is an outbreak happening in the middle of the main vaccination programs. That will screw up are complex logistics if a mass vaccination program.

Normal life should resume inside NZ and Australia about the time that we have about an 70-80% double vaccination rate. The earliest that is likely to happen in around the end of this year, and possibly longer in Australia.

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