Thank you so much. Good morning, everyone. My name is Isaac Bogoch. I'm an infectious diseases physician and scientist based out of the Toronto General Hospital and the University of Toronto. Thank you for inviting me to speak at this committee meeting regarding the COVID-19 second wave in Canada.
The focus of my few minutes is to discuss an exit strategy from this wave, and from the pandemic in general, with an emphasis on vaccination but also touching on other issues including non-pharmaceutical interventions.
The ultimate goal here is to halt our second wave and to prevent further waves of COVID-19. Now, most regions of Canada have emerged from peak cases in December or early January and are seeing a steady decline or a plateau in cases due to our current control initiatives. While this is laudable, we still have a long way to go. Vaccines are trickling in, but we won't really be able to really start massive expansion of these programs until the spring, so programs are appropriately focusing on those at risk or at greatest risk of severe outcomes.
I want to touch on three big topics: what's working in our favour; what is working against us; and how we navigate the winter, the spring and beyond.
Let's start with what's working in our favour. Number one, we have vaccines. Of course, the current short-term slowdown is preventing expansion of these programs, but we still have some and we're making good use of what we have.
Just to state the obvious, the sooner we ramp up these programs, the better. All vaccines approved by Health Canada and those under consideration have excellent efficacy against the virus, including the variant discovered in the U.K., while there is lower efficacy on other variants of concern—for example the one discovered in South Africa. However, the vaccines still appear to reduce infection, prevent severe illness, prevent hospitalization and prevent death—all very important metrics.
The second thing working in our favour is weather. Believe it or not, weather in Canada is actually working in our favour. As we leave winter, as we enter the spring and summer, warmer weather means less contact in indoor settings, where the vast majority of virus is transmitted. These fewer high-risk contacts add up at a population level and are going to help.
The third thing is that our current public health measures are working in much of Canada, and in general, Canadians are adhering to them.
What's working against us? Number one are the variants of concern. For example, the variant discovered in the U.K.—that's the B117 variant—is more transmissible and has a strong foothold in Canada. We have to respect this. We have to take it seriously. We need to drill down on our current control efforts until vaccine rollout is more widespread.
The second thing working against us is anything that jeopardizes vaccine delivery. This is way above my pay grade, and I'm going to leave it to you to sort that out.
The third thing is vaccine hesitancy. This is pronounced in some communities, but it's still important, and we have to address it.
The fourth thing is targeting misinformation and focusing on better communication, from both official and non-official sources. This is beyond the scope of my time, but it's still a huge problem that's impacting the pandemic in Canada and beyond.
The fifth thing is COVID fatigue. It's real. It's permeating all aspects of Canada. We can't let our guard down, especially as we see a finish line on the horizon.
Lastly, how do we stickhandle our way through the winter and into the spring and beyond?
First, we need to be very careful, and have a careful and measured reopening strategy, especially while vaccines are slowly being rolled out. The variant discovered in the U.K. will make this more challenging, but it can be done. It's foolish to lift public health measures if the drivers of community infection are not addressed. Vaccine rollout will not be widespread until the spring. There's no point having more lockdowns. Lifting measures has to be done at the right time, slowly and carefully.
Second, related to the point above, is creating safer indoor environments, and that includes schools and workplaces for essential workers and those returning to work. That means integrating rapid diagnostic tests or rapid screening tests, improving ventilation in these settings, having smaller class sizes, and providing wraparound services to ensure equitable access to safety and protection, etc.
Third is vaccine distribution. Now, let's separate politics from science for a second. It may be an unpopular political opinion, but it makes sense in terms of medicine, science and public health to divert vaccines from low-burden areas of the country that are able to control the virus to more heavily impacted areas while there is still a shortage.
Fourth is vaccine supply in the short term. Health Canada has to conduct its evaluation independently, but the faster we vaccinate, the faster we'll be out of this mess. Johnson & Johnson, Novavax and AstraZeneca are three products with excellent phase three clinical trial data. We have contracts with them. They are sorely needed.
Last is a long-term strategy. It's crucial to support Canadian scientists and Canadian industry in homegrown vaccine production. This is a major weakness and a major health security issue.
We have the talent and capability here, and it's long past time to enhance and expand these programs.
It's hard to sum up all that's required to strategically navigate the second wave in five minutes, but I hope that we can continue this conversation. I thank you for your time.