A Footrace We May Be Winning

This week's COVID news continues to be almost entirely good, despite growing evidence that we are racing to get fully vaccinated before the Delta variant catches up to us.


The number of new cases in Ontario fell to 345 today; Toronto, which once made up close to half of the provincial total, fell even more dramatically to 50 – the lowest since September.


It's a remarkable achievement, caused by a combination of effective government measures, public co-operation, and an extremely strong vaccine take-up by residents, especially in Toronto. About 75% of us adults now have at least one dose, and close to 25% are fully vaccinated.


Bookings have been difficult to come by this week, but the City is adding 30,000 doses today for next week and another 60,000 Monday for the week of June 28.


All of these additional doses will be Moderna, as large shipments of that vaccine start to arrive. Toronto's clinics will now be administering the virtually identical and interchangeable Pfizer and Moderna vaccines, both of which use mRNA technology. They are equally safe and effective.


Pfizer is the only vaccine currently authorized for the 12-17 age group. Please note that, to be eligible, you must already have reached your 12th birthday. Remarkably, more than 60% in that age group in Toronto has received a first dose – an important factor in creating a safe return to school in September, by which time these students can be fully vaccinated.


Pfizer is expected to apply for approval for use of its vaccine in 5-11 year-olds by September. So there is a strong possibility that this age group can be vaccinated before the end of the year.


Some other important updates:


Eligibility for Second Doses

Any Toronto residents who received a first vaccine shot on or before May 9 can already book a second dose through the provincial portal. As of next Wednesday (June 23), anyone in a hot spot like Toronto who had a first shot on or before May 30 can book a second one. Sometime during the week of June 28, all Ontarians can book a second shot if they had their first shot at least 28 days earlier.


Please try to book a second dose appointment at your first opportunity. And, if you know anyone who hasn't yet received a first shot, please encourage them to make that a priority.


In addition to the city-run clinics, vaccines continue to be available through pharmacies, hospitals, pop-up clinics and physicians.


Dangerous Delta and Protective Vaccines

The Delta variant continues to sweep through several countries, including those which thought they had COVID under control. In Britain, a re-opening plan was postponed four weeks as cases increased by 120% in only two weeks. Although the nation has a high vaccination rate, Delta has spread rapidly among those who are unvaccinated or not fully vaccinated.


Delta is already becoming the dominant strain in Ontario and we are only a few weeks behind Britain in its trajectory, so the same could happen here if we don't act to prevent it. It is approximately 50% more transmissible than the Alpha version of the virus, which originated in Britain, and that was already 50% more transmissible than the type that came from Wuhan.


In Moscow, cases have tripled in three weeks, reaching their highest numbers since the start of the pandemic. This week, a Delta outbreak in Waterloo caused it to become the worst hot spot in Ontario. As an example of how quickly the danger can travel, it is speculated that the Waterloo problem originated with workers returning home after an outbreak at closed a mine in Nunavut.


Early information out of Britain indicates that Delta may also produce more severe illness.


If extremely effective vaccines had not been developed in record time, the exponential growth of this variant would have killed many more than those who have already died from the virus; we would not now be contemplating a return to some sort of normal.


Fortunately, all approved vaccines have shown themselves to be effective at combatting Delta, especially after two doses. There are two common ways of measuring vaccine effectiveness: the spread of symptomatic infections and hospitalizations.


A UK study released last month caused great alarm when it showed that those who had received just one dose of the vaccine were only 33% protected from catching COVID. But those numbers rose to 88% for Pfizer and 60% for AstraZeneca after two doses.


This week, a study measuring hospitalizations was even more reassuring. In a study of 14,000 people infected with the Delta variant, a double dose of Pfizer was 96% effective in preventing hospitalization. In the same study, AstraZeneca was 92% effective. Even after only one dose, the protection against hospitalization was 94% and 71%.


When you combine the results of these early studies, even against the Delta variant, you are unlikely to get COVID if vaccinated, and very unlikely to get seriously ill from it. But the risk is certainly not zero, so even those who are fully vaccinated should remain cautious until everyone they interact with is too.


New AstraZeneca Advice – Again

Although the data above demonstrates that getting two doses of AstraZeneca as soon as you could was not a bad choice, Canada's National Advisory Committee on Immunization (NACI) this week recommended that those who still have a choice get Pfizer or Moderna for their second shot.


Over the course of this year, people have been told to take the first vaccine they can get, that their first and second doses should be the same, then that Pfizer/Moderna were "preferentially" better for those getting their first dose, that it was ok to mix vaccines, and finally that it was better to skip AstraZeneca entirely for a second shot, even if that was your first dose. Those who prefer to have a second dose of AstraZeneca to match their first can still choose to do so.


Changing advice as new information becomes available is not a bad way for a scientific body like NACI to operate. But it must be frustrating to those who relied on expert advice one week to have it change the next, and then again after that.


The new new advice was based on a combination of factors: that AstraZeneca posed a risk of blood clotting that was extremely small but unnecessary when there were other vaccines to choose from; studies showing that it was safe to mix and match; a new study from Germany indicating that adding an mRNA second dose to a first shot of AstraZeneca provides a higher level of protection. Results of a major study by Oxford University on this last point is expected later this month.



And now, for a welcome change of subject, this week's song is for all the Dad's who've been a pal to their children. And yes, that little person in the video really was only four years old when this was recorded.


-John