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COVID-19: 100 Days of Progress

COVID-19 Insights May 04, 2021
COVID-19 Insights May 04, 2021
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With the Biden administration 100 days into deploying against the Coronavirus, BMO guest medical experts, Dr. John Whyte, Chief Medical Officer, WebMD and Dr. Allison McGeer, Senior Clinician-Scientist, Lunenfeld-Tanenbaum Research Institute, Sinai Health, joined our client call to assess the fight against the third wave of COVID-19.

By the Numbers

In the United States, data shows tremendous progress since new measures were taken to ramp up vaccinations and testing, Dr. Whyte said, with the seven-day, average daily new case count standing at some 49,000, a fraction of the 200,000 per day rate when Biden first took office. Similarly, the seven-day average for daily new deaths is around 650, compared to over 3,000 daily in January.

When it comes to COVID-19 vaccinations, approximately 147 million Americans, or 45% of the population, have had a first dose of either of the two-dose vaccines, Moderna and Pfizer, with around one third of the population now fully vaccinated. More importantly, approximately 85% of Americans over the age of 65 have now had their first dose, and nearly 75% have received both doses and are fully immunized.

“This is a success of the vaccination program,” Dr. Whyte said, adding that he’d like to see case counts and deaths drop a lot more.

Vaccine Hesitancy

The vaccine rollout has been so strong that demand has started to wane – in April there were 3-4 million doses being administered daily, and now the average is around 2.6 million doses, but Dr. Whyte said the challenge now is to address vaccine hesitancy. Because the younger population, aged 18-24, may be driving the current spread of cases, greater communication to that cohort is now even more important.

Surveys indicate around 25% of the population does not plan to get a vaccine, so a combination of good communication, easy access, and incentivizing vaccination will be key. Healthcare professionals need to communicate to the public that mortality isn’t the only risk to contracting COVID-19, Dr. Whyte said, pointing at the need to protect the community as well.

“This is one of the most powerful speeches to those that are hesitant as to why you get the vaccine,” Barclay added, saying that part of what drove him to get the AstraZeneca vaccine several weeks ago was the need to protect the community and those around him.

To address accessibility as another driver of vaccine hesitancy, Dr. Whyte noted that the vaccine rollout has expanded to malls and gas stations, and health officials in some rural areas are starting to bring the vaccines to people in their homes.

Finally, more than 100 universities and colleges say a COVID-19 vaccination will be required for students to return in the fall.

The Case of Canada

Sinai Health’s Dr. Allison McGeer noted how far the U.S. has come in recent months, reversing a poor record in the first two waves of the pandemic.

“I think we'd all like to be where the U.S. is now, which is an interesting reversal,” she added.

Currently, about 40% of eligible Canadians have had their first dose of a vaccine, which puts Canada about six weeks or even two months behind the U.S., according to Dr. McGeer. In contrast to the United States, Canada is pursuing the UK strategy, which is to get as many first doses into as many Canadian arms as possible, in part because Canada has not had enough vaccines to administer second doses to everyone yet.

One important challenge to Canada in this third wave, McGeer explained, has been a hospital bed capacity that is significantly lower than in the United States. As a result, several hospital units across Canada are nearly stretched to their limits with the current spike in ICU admissions.

As cases begin a slow decline in most of Canada (the exception being in the province of Alberta), the question will be whether Canada can replicate the rapid decline in cases seen in the UK, which occurred amid a simultaneous vaccine drive and lockdown. Based on the UK model, McGeer said Canada could see significant improvements by the end of May, or the end of June, depending on the relative contribution of lockdowns and the vaccine drive.

The Variants of Concern

With multiple variants of concern (VOCs) fueling the current COVID-19 wave, both in Canada and abroad, the question has become: how effective are the vaccines against these variants? The Pfizer and Moderna vaccines have demonstrated significant efficacy, Dr. Whyte explained, typically around 90%, against the known variants.

The key, both doctors noted, is herd immunity – not just nationally, but globally, since variants are appearing in different geographies soon after they are first detected in a country of origin.

“The way to deal with this virus is to look at ourselves as one planet, and to get vaccines to everybody as quickly as we can,” Dr. McGeer said.

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