Ontario’s COVID-19 vaccine plan has a ‘huge hole,’ despite boost in hot spot supply and 18+ eligibility, doctor says

With the Ontario government announcing that 50 per cent of the province's vaccine supply will be allocated to hot spot areas for the weeks of May 3 and May 10, Dr. Naheed Dosani, a palliative care physician and health justice activist, says this is "a step in the right direction."

"I am certainly hopeful that this will make a difference and improve access for hot spot communities because what we've seen with the long lineups in Scarborough and Peel, and other hot spots, is that people want vaccines, they've just structurally lacked access to them," Dr. Dosani told Yahoo Canada.

Data from the Ontario COVID-19 Science Advisory Table two weeks ago showed that if the province allocated 50 per cent of vaccine supply to the top 20 per cent incidence neighbourhoods, that could significantly impact control of the pandemic, based on Ontario administering about 100,000 vaccines per day.

The data showed that an age-based allocation takes about 59 vaccines to avert a case, instead of about 34 with this more targeted approach.

"As soon as hot spots [were] being noted, it really should have pushed our government to transition and think deeply about what an equity informed approach to vaccine distribution looks like," Dr. Dosani said. "I wonder if we would be in a different place had that happened."

Family doctors seemingly left out of vaccine rollout

While the provincial government states that during the two-week period of hot spot prioritization vaccine supply will be distributed to mobile teams, pop-up clinics, mass immunization clinics, hospitals, primary care and pharmacies, there continues to be little concrete information about expanding vaccine administration through family doctors, primary care physicians.

"I think a huge hole in this rollout plan has been the fact that family doctors and primary care in general has been left out and even in today's announcement, there seems to be very little content around that" Dr. Dosani said. "[Family doctors] have access to a significant patient population, they're really good at counselling people and we've even now had successful pilots across the province as well."

The announcement about the expanded vaccine plan on Thursday also includes anyone in Ontario age 18 and older being able book an appointment for a COVID-19 vaccine through the provincial booking system as early as May 24. Beginning on Friday, April 30 at 8:00 a.m., individuals 55 and older across Ontario will be eligible to make a COVID-19 vaccine appointment through the provincial booking system.

Dr. Dosani does understand why some people may be anxious about the Ontario government's plan, especially when many have called out how difficult it is to actually book an appointment, but says we have to have some "hope and optimism" during this time.

"This has been a very difficult time for a lot of people and we've been given a lot of promises that were not delivered upon," he said. "With that said...the reallocation of vaccines to hotspots is a really positive sign, more people are getting vaccinated day by day and we have to collectively support each other to get to that light at the end of the tunnel."

While vaccinations are an important aspect in fighting COVID-19, one area Dr. Dosani would love to see more efforts is public education on personal behaviour, particularly after individuals receive one dose of a COVID-19 vaccine and are waiting for their second dose.

"This has been something that many of the people I care for are confused about and I think further guidance around nuanced issues like that is really important," he said.

"We have to recognize that many people don't watch afternoon press conferences. We need to use social media messaging services, ethnic media to get out to make sure this message is given out to people in an equitable way. We can't take our foot off the gas, this is the time to continue with a sustained effort, so we can ultimately all get through this."

'We have seen enough of how our politicians are playing politics with people's lives'

Ultimately, Dr. Dosani identifies that the Ontario government is starting to respond to health experts and frontline health workers, even though the introduction of some of these measures have been "slow" or what he calls a "half measure," specifically for the three paid sick days announced on Wednesday.

"It's unfortunate that the Ontario government does not seem to want to strive for what could be the best-case scenario and in the case of paid sick days, offering three paid sick days is a good example of a half measure, once again, particularly for a virus that requires individuals to isolate for a minimum of 10 days," Dr. Dosani said.

"I certainly hope that the Ontario government is going to be listening to experts and frontline health workers more moving forward, we have seen enough of how our politicians are playing politics with people's lives."

At a press conference on Thursday afternoon, Dr. Adalsteinn Brown, co-chair of the Ontario COVID-19 Science Advisory Table, was asked if the sick leave program presented by the provincial government meets the threshold for "strong effective sick pay" used to model the province's "best case" COVID-19 situation.

"We've modelled the strong effective sick pay as beginning immediately, lasting for essentially two work weeks, so 10 days, and being at a level that allows people to not have to make difficult choices," Dr. Brown explained. "What you saw is something that [deals with the] quick initiation of it, paid through employers, it's at a higher level and it is for a shorter period of time than we suggest is necessary."

"So it's a good start but it doesn't reflect the assumptions that we've made, based on the programs we've seen elsewhere."

When asked specifically if "the current policy status quo" aligns with the assumptions of the best case scenario Dr. Brown simply answered, "No."