As a 95-year-old with a chronic lung disease, Victoria Burda is among the Canadians facing a high risk of severe illness from COVID-19.
The North York resident is slated to get her first vaccine dose on Friday, but her daughter, Cherise Burda, said the process has been rife with complications — all because her mother lives in her own home instead of in a long-term care facility.
"My mother is fortunate to have children who are advocating for her, getting her an appointment and putting a team together to get her a wheelchair and stand in a long lineup for her," she explained.
"I worry about the at-risk elderly who are homebound and don't have anyone to help them."
As Ontario ramps up vaccination efforts for older adults in the community, health-care workers say elderly people living at home need to be better accommodated to ensure high-risk residents don't slip through the cracks.
That's a major concern for Jodi Verburg, a personal support worker in Brockville, Ont. who worries some of her elderly home-care clients could wind up missing out on vaccination programs entirely.
"It's almost like out of sight, out of mind," she said, "if they don't have anybody to speak up for them except for us PSWs who go in, and family members."
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In Georgetown, Ont., family physician Dr. Nadia Alam said she's already hearing from some elderly patients that the entire process of getting vaccinated is a challenge, right from the moment people try to book an appointment.
Online portals, she explained, can be tricky to navigate for some seniors.
"You have to understand how to turn on the computer, have the manual dexterity to type in the website … and then navigate a multi-page website, which goes into your health history," Alam said.
Getting to a vaccination centre can be a challenge as well. Some seniors don't drive anymore, or simply don't have access to a vehicle, meaning they need to find a ride or use public transit — not an easy feat for many isolated elderly residents.
"You have to be able to climb in, climb out. You have to be able to stand in line," Alam continued.
"And then, you have to go into a very large environment where there's going to be a lot of activity, a lot of stimulation, a lot of directions that you have to follow — so it's it's not easy for everybody, and that's the population we may miss because they tend to be high risk patients."
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Elderly remain bulk of COVID-19 deaths
In Ontario, more than 7,000 people have died of COVID-19 since the start of the pandemic, and roughly 95 per cent of those deaths were among people over the age of 60, with the bulk being 80-plus.
Many of those deaths happened in long-term care homes — more than 3,870 in total — while plenty of others were seniors living in the broader community.
Alam questioned why vaccinations aren't now being rolled out broadly in family physician offices, which already have close relationships with their elderly patients.
"I think the solution really is to address this group distinctly as an at-risk group, and trying to determine how to give them specific times for an appointment, and to prioritize them," Burda said.
So far, COVID-19 vaccinations in Ontario beyond the long-term care sector have largely taken place within the hospital system, with each of the province's 34 local public health units now rolling out their own distinct plans for community-based clinics, mass vaccination sites and other approaches.
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Starting this Friday, roughly 133,000 COVID-19 vaccination appointments for people aged 80 and up will become available at several mass immunization clinics being operated by Toronto Public Health.
The province also announced at least 325 pharmacies will be offering the AstraZeneca vaccine for people aged 60 to 64 — a younger group getting access based on federal advisory body recommendations against using it for older seniors — but, again, the bulk won't be through family physicians.
Of the close to 200,000 AstraZeneca doses being given out this round, community-based doctors' offices will receive fewer than 30,000 doses, the province said, while pharmacies will be allotted the majority.
Speaking to the media at Ontario's Wednesday announcement, Premier Doug Ford did note family physicians will be contacting eligible Ontarians as vaccinations in primary care settings are set to start this weekend.
"The light at the end of the tunnel keeps getting brighter," he said. "Please be patient; we will get through this."
Ford's team did not take a question from CBC Toronto at the news conference, and the Ministry of Health did not respond to an emailed inquiry by publication time.
However, Dr. Isaac Bogoch, a member of Ontario's vaccine task force, did stress there are various programs that are mobilizing to help elderly residents who are living at home.
One pilot program in Toronto's east end, for instance, which had the backing of both Toronto and provincial health officials, delivered vaccines directly to hundreds of seniors in a non-profit housing complex.
That kind of initiative is in addition to community-based organizations that are "really going to help identify people, sign them up and mobilize them to vaccine centres," Bogoch said.
"It also involves everyone rolling up their sleeves and doing their bit," he added.
"So that also means family members, and neighbours and friends need to really look out for one another, to ensure that people get the assistance they need to sign up for vaccination, and mobilize to a vaccine centre," Bogoch continued.
"It really will require all hands on deck."