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Zalan: North’s higher percentage of older people means we need more vaccine doses

Dr. Peter Zalan says Northern Ontario’s higher population of people over 65 and spiking cases in Thunder Bay and Sudbury suggest not only a need for a greater vaccine allocation but also a more innovative approach to getting vaccines to the people who need it most

On March 5, any individual born in 1941 or earlier became eligible in Ontario to pre-register for a COVID-19 vaccination appointment. 

I was excited. It has been so long waiting for these words. I notified all the eligible individuals that I knew. 

Happily, they have all been vaccinated at Carmichael Arena. Their reports about the process were universally glowing. They were also excited about the freedom that this promised. 

A delightful senior, well into her 80s, was asked on arrival at the Vaccination Centre if she had been out of the country recently. 

“My dear,” she replied. “I have been hiding out in my house since this pandemic began.” There were 1,700 eligible seniors vaccinated last week. More this week.

 The downside to this story is the large number of seniors that remain to be vaccinated. 

The U.K. variant is running wild in our community. Our numbers are rising dramatically: 27 total on Feb. 24 and 242 total yesterday, just 21 days later. About half of those cases are caused by the variant. 

We went into lockdown last week. Primary and secondary schools have been closed. Medical Officers of Health have attributed most cases to household clusters. It has proved difficult to self-isolate away from other household members. 

In Barrie, to date, 831 cases have screened/tested positive for all three variants: from the U.K, Brazil and South Africa. The highway between Barrie and Sudbury remains fully open.  

Ontario is expecting to receive 1,454,310 doses of the Pfizer and 483,700 doses of the Moderna vaccine in the month of March. Thirteen public health units, designated hot spots of infection by the province, will receive additional doses on top of their earlier allotment. 

This was announced on March 5, the same day the province announced that Sudbury was going into lockdown. It is peculiar that of the 13 eligible regions, only two are in lockdown, all 13 are in Southern Ontario and the two regions in lockdown in Northern Ontario — Sudbury and Thunder Bay — are not so designated. 

It is hard to understand because Thunder Bay has been transferring Intensive Care Unit patients all over Ontario due to lack of capacity. The city needs help. Sudbury numbers are rising rapidly with three new outbreaks at Health Sciences North. Our community also needs help.

Moreover, the percentage of seniors over the age of 65 is significantly higher in Northern Ontario than in the south: about 20 per cent in the North and 12 to 16 per cent in the south. 

Here is data from Israel: 47 percent of Israelis have now been fully inoculated and 55 per cent have received a single dose, the highest percentages in the world. 

“We checked the medical files of 150 coronavirus fatalities. We saw a steep rise in mortality during the third wave, when 90 per cent of them had the U.K. strain. If the death rate of hospitalized patients was about 6.5 per cent during the first and second waves, that figure rose to over 10 per cent during the third wave,” said Dr. Dror Mevorach, head of Hadassah Hospital’s Coronavirus Unit told Haaretz on Mar. 14.

The variant causes a more serious disease. On the other hand, new COVID-19 cases have continued to fall dramatically; the number of Israelis with serious illness and requiring hospitalization is hitting new lows. Vaccination works.

Another cause for optimism: After the immunization of most clients in Ontario’s long-term care homes, there have been few deaths due to the coronavirus. 

The City of Greater Sudbury and Public Health Sudbury & Districts have just announced a pilot project in which local paramedics will administer the vaccine in the homes of homebound individuals. It will help ensure access to the vaccine for those who are unable to attend a community clinic due to medical or physical restrictions. Public Health Nurses will prepare the vaccines and City paramedics will transport and administer the vaccines in the person’s home. A wonderful innovation.

What is the role for family doctors? I wonder because my family doctor has successfully vaccinated me over the years. I know he has made house calls to homebound patients to administer the vaccine when they could not come to his office. Family doctors understand these complex elderly patients. In turn, their patients trust them.

When questioned as to the role of family doctors, Public Health Sudbury said that it would be too complicated for them to participate at this time. They also mentioned that home vaccination is awaiting the arrival of vaccines. 

In summary, COVID-19 infection numbers are exploding. The variants are spreading rapidly throughout Canada, including Sudbury. They are highly transmissible and more deadly for older age groups. Younger people are the major carriers of the infection, travelling between households, schools and social gatherings.

For individuals most at risk, folks over 65, stay away from younger people. Get vaccinated. The vaccine works.

Premier Doug Ford, please re-allocate extra vaccines to the North. We have a higher percentage of individuals over 65 and have two hot spots of infection, Sudbury and Thunder Bay. The vaccines belong to everyone. 

Dr. Penny Sutcliffe (medical officer of health), please allocate vaccines to both family doctors and paramedics.

Please do not travel. For sure, do not go to Barrie, the epicentre of the variant. Other northern health units are now advising their public to stay out of Sudbury. Quite ironic considering, not long ago, Mayor Brian Bigger was imploring the premier for a Northern Bubble. We all know how that worked out. 

Dr. Peter Zalan is past president of the medical staff at Health Sciences North.