Q&A: Dr. Michael Gardam on vaccine rollout and the current COVID-19 situation

·5 min read

As P.E.I. ramps up its vaccination rollout, the federal government said Friday that more shipments are expected to be delivered to Canada weekly.

The news comes while some provinces continue to set new records for COVID-19 case diagnoses. Dr. Michael Gardam, an infection control and disease specialist and senior medical adviser at Health PEI, says P.E.I. has done very well with its vaccine rollout so far.

"In comparison to the other provinces, P.E.I. is ranked at the top of the list. P.E.I. has done very well," Gardam told CBC News: Compass host Louise Martin.

He acknowledged that the province has a geographical advantage by being an island and able to control who enters its borders, but "the fact remains — I mean, from the very beginning, the P.E.I. response has been very aggressive and very, very quick. And that's gotten us to where we are today."

Prince Edward Island has confirmed only 102 cases in the last 10 months, with no hospitalizations, no deaths and little sign of community spread.

Here is more of CBC's conversation with Gardam, edited for clarity and length.

We saw shocking numbers out of Ontario today — more than 4,200 cases, a startling contrast to the numbers here on P.E.I. How did it get so bad there?

There's no one answer to how Ontario got into the trouble that it got into, but certainly part of it is Ontario was always going to get into more trouble than P.E.I., because of its size and how interconnected it is with other provinces and with the United States.

It's also been the story from the very beginning: The government has been very reluctant to be very aggressive with the virus. Typically, if people were calling for some sort of lockdown or partial lockdown at the beginning of the month, we'd start implementing something at the end of the month and so we would be delayed by several weeks. When you have exponential increases in viral numbers, every day that you wait, it gets worse faster.

As the vaccine rollout continues, and we have some people who are vaccinated and others who aren't, what kind of issues can that raise?

The more people we get vaccinated, the better. It is going to lead to a bit of confusion. There are many questions around whether vaccination means an individual still needs to play by the public health rules, wear a mask and physically distance.

There's two main answers to that. One is that it has yet to be proven that being vaccinated actually prevents you from getting infected. The theoretical concern is that although vaccination clearly prevents you from getting serious illness, which is very important, we don't know yet whether it actually prevents you from getting infected. There's a concern that you could still be shedding virus and running around, potentially spreading it to people. So we need you to still play by the rules until we figure out whether that's true or not. Likely the vaccine is going to prevent infection, but we need to prove it.

The second thing is if I'm running around Charlottetown, not wearing a mask and disobeying all the rules, other people are going to see me and how are they going to know that I am doing this because I've been vaccinated? This is something I've seen and witnessed in many outbreaks in the past. Everybody kind of has to follow the rules or it gets very confusing and things break down.

There is some new data today that suggests the Pfizer-BioNTech vaccine will work against a key mutation in the new variants discovered in Britain and South Africa. How reassuring is that to you?

It's very reassuring. I think most people expected that was going to be the case, but whenever you get a new variant like this and there's all the concerns that it seems to be spreading more easily and it has an unusually high number of mutations, it's really important that you prove your vaccine still works. And thus far, from that small study we are in, we're in good shape.

That is what we predicted, but it's nice to actually prove it.

There has been a lot of discussion about half-doses of the vaccine, delaying the second dose in places, or even mixing Moderna and Pfizer-BioNTech in some cases. What's the thinking about all that right now?

The world's really kind of split on those two things. There's people — and I'm one of them — who believe that if you've studied a vaccine with a particular dose and with a particular interval between the doses, you should follow that. That's where your evidence is and that's where your evidence is telling you that these vaccines work.

When you start cutting the doses in half or you start mixing vaccines or you start spreading out the dosing interval, we don't have evidence that that's going to work. There may be a theoretical reason why that's probably OK, but I'm not a fan of the word "probably". - Dr. Michael Gardam

When you start cutting the doses in half or you start mixing vaccines or you start spreading out the dosing interval, we don't have evidence that that's going to work. There may be a theoretical reason why that's probably OK, but I'm not a fan of the word 'probably'. We have very clear evidence: If you follow the dosing schedule, these work really well. I would rather we stick with that.

The reason places are talking about these changes is because there is a real concern about the number of cases and they're trying to reach the maximum number of people possible. I understand all that. My concern is that we don't want to get in a situation two or three months from now where we realize we messed with the vaccination schedule too much and now those people actually aren't as protected for as long as we hoped they would be.

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