If you grew up in these parts and have been around long enough, you certainly remember Expo 86. The world came to visit, and the city hasn’t been the same since.
One thing that most people who visited the World’s Fair had was an Expo passport. You’d carry it around and get stamps from everywhere you visited at the fair. Somewhere in my basement storage is my well-tattered Expo passport, and it’s full of pretty-much every stamp that existed. Every pavilion, every restaurant, every ride, every kiosk… all had their own unique stamp, and it became my mission to get them all. Even the Expo 86 mascot, Expo Ernie, had one… and if you could find him wandering around, he’d stamp your passport too.
There were a few very rare ones… like, for example, Jimmy Pattison. He had his own stamp, and the story of how I got him to stamp my passport is pretty good. Jimmy P, the well-known legendary-yet-ruthless businessman / epic philanthropist / CEO of Expo 86, at least back then, drove a monster of a car… like one of those 8-gallons-to-the-mile Lincoln Continentals from the early 80s. And maneuvering a big car like that around the tight spaces surrounding the fair wasn’t so easy, I guess… and, on one bright sunny summer day in 1986, he almost ran me over. It wasn’t actually that close, and I wasn’t actually that shaken up… but he stopped and made sure I was ok and asked if I needed anything. Yes, Jimmy, in fact I do… and that is how I got the coveted JP Expo 86 passport stamp.
It’s starting to feel like any sort of vaccine passport will have the look and feel of an Expo passport, where instead of visiting countries and getting their stamp, you’ll visit their vaccines and get those.
What’s starting to become apparent is that there is no such thing as *the* vaccine. That was a concept we all collectively came up with last year; “once *the* vaccine shows up, we’ll all be saved.”
Not so simple now, is it.
All vaccines are not created equal. And even if they were, it seems some vaccines are more equal than others. We’re starting to see some hints of vaccine “protectionism”… like, in the U.S., if you want to go to the Springsteen concert (yeah, how appropriate… Born… In The U.S.A….), you will need an American-made vaccine. Pfizer? Yeah man. Moderna? Sure dude. AstraZeneca? Not so fast, old chap.
This morning, Singapore began offering the Chinese-made Sinovac vaccine, and clinics were overrun with demand. This, notwithstanding the fact that Pfizer and Moderna have been available there for a long time, and half the population of 5.7 million have already had one or the other. And notwithstanding that Pfizer/Moderna have efficacy rates of around 95% while Sinovac is only 51%.
None of that matters. What matters is… that if you’re a Chinese national who lives in Singapore and wants to travel to mainland China, the only way to avoid quarantine upon arrival is to have the Sinovac vaccine. Oh, you’ve already had two shots of Pfizer and are completely immune? That’s nice, but if you want to visit our country hassle-free, you’ll have to have this one as well.
And so, perhaps, once it’s established that there’s no way to O.D. on vaccine, people will have some decisions to make. If AstraZeneca is going to be treated like a second-class citizen south of the border, what do you do? What does it mean for those who’ve had two doses of AZ and want to cross the border? What if you’ve had one AZ and one Pfizer/Moderna? What if you’ve had AZ, Sinovac, J&J *and* Sputnik? What if you’re so loaded with vaccine that you’re immune till 2027 and serve as your own 5G beacon?
These are not irrelevant questions. The U.S. may consider AZ a 2nd-tier vaccine just like China considers Pfizer/Moderna… but Canada will end up making its own policies as well. And it’s going to get messy, because people will scream discrimination. And, of course, that’s exactly what it is. Little of this has anything to do with actual science or vaccine efficacy or actual practicality. It’s mostly just bullshit politics.
One of the tag lines of Expo 86 was about “Inviting The World”, which we certainly did. And we still do… though, in future… well, bring your well-stamped passport with you.
Since 1980, the Vancouver Canucks have won fewer than 10 Stanley Cups. Also, since 1980, the Edmonton Oilers as well… have won fewer than 10 Stanley Cups.
While both of those facts are entirely accurate, they certainly fail to convey the real picture. But someone who’s not too sure can make that blanket statement, and nobody will argue it… though it might make you wonder if the person who said it actually understands what they’re talking about.
Similarly, the CDC has announced that “less than 10 percent” of C19 transmission is occurring outdoors. This number was picked up by the media and repeated… and has become the “de-facto” standard accepted description for the frequency of outdoor transmission. And sure, it’s without-a-doubt – accurate. The number is most certainly less than 10%.
What’s the real number? The actual number of documented outdoor transmissions may actually be lower than 0.1%, and even that is questionable. It may be a lot lower than that.
Part of it is defining what’s an outdoor space. A poorly-ventilated tent is not an outdoor space, though some stats have classified it that way. A huge outlier in outdoor transmissions has been data from construction sites in Singapore. For example, one particular study of over 10,000 worldwide instances of transmission found that only 95 of them were outdoors… and all 95 of them were from construction sites in Singapore. What gives?
That’s pretty simple, actually… those guys work outdoors in the hot sun, but eat lunch and congregate and relax in cool construction trailers, sometimes for lengthy periods of time. But since the job overlaps with indoor and outdoor spaces, and the classification needs one or the other, they erred on the side of caution and labelled it outdoor.
This erring on the side of caution is a problem, because it’s led to a lot of confusion and uncertainty. What exactly is risky? When exactly do you need a mask?
What the evidence is showing (though the guidelines still have to catch up) is that the highest risk – perhaps the only risk – is indoor spaces, especially ones that are poorly ventilated. Should you wear a mask while shopping? For the moment, absolutely. Vaccinated/not vaccinated/healthy/recovered… whatever… wear a mask. And understand why being in a crowded restaurant or bar for several hours is a lot different than a quick in-and-out at the mall to pick up something you need.
There are a lot of people wearing masks outdoors, but the science is implying that it’s almost entirely unnecessary. Sitting outside for several hours in close proximity to a lot of people is still not a good idea. Sitting outside next to one particular person, talking for hours, is also still not a good idea. It’s not an issue of being inside or outside; it’s an issue of proximity and potential viral load. Someone infectious breathing on you with conversation for hours is a risk, no matter what the venue. But when you’re outside, even a concentrated blast of virus dissipates very quickly. The distinction between droplets and aerosols and where they come from and how far they can reach and how long they can linger… all of it becomes rather moot when you’re outside, as in truly outside. It disperses… quickly.
So what about walking around on the street? Sitting around on a park bench by yourself? Should you be wearing a mask? As it turns out, the negligible risk implies maybe not. It might be the equivalent of walking down the street wearing a helmet… just in case a flowerpot falls off a window ledge.
An analysis of over 7,000 cases in China found exactly one case of outdoor transmission… but it was two people in conversation, in close proximity, for a lengthy period of time. And many other studies have concluded the risk of outdoor transmission to be insignificant.
That particular 0.1% number comes from analyzing numbers in Ireland… roughly 260,000 cases, roughly 260 of which were classified outdoors… but, again, that included construction sites and people in close proximity for long periods of time… with perhaps some indoor time included. Also, some sporting events… but it’s changing rooms before and after that are the real threat. Covid-19 ripped through the Canucks dressing room and affected most of the players and coaches and some others. But no opposing players caught it from any Canuck.
But… we’ve been erring on the side of caution, and we’ve gotten used to it… and it’ll be a while before people are comfortable with the idea of being around others without a mask, no matter where you are. And for the all-or-nothing crowd – where the only choices are black or white, right or wrong… there’s no easy way to convey this information. At the end of the day, there are circumstances where a mask is absolutely necessary. But by providing one single case where it’s not, you’ll hear back “You see?! We don’t need masks blah blah blah I’m not listening blah blah blah!!” – end of discussion.
So… as exaggerated as it’s been, that’s been the messaging. It covers the all-or-nothing crowd, much like saying the Canucks have won fewer than 10 Stanley Cups.
I, for one, would love to see the Canucks win at least one in my lifetime… and I’d like it to be in a crowded Rogers Arena along with 20,000 other people. And the silver lining of this is that, of course, by the time the Canucks are in any shape to win a Stanley Cup, masks will long have been a thing of the past.
But for now, if you need a general rule, wear a mask. And if you understand the big picture of all of the above, and especially if you’ve already had a jab or two… you can certainly start thinking about taking it off outdoors, especially if there’s nobody around.
I realize this isn’t yet the official messaging, but soon enough, it will be… because if you believe in science… and it’s the science that’s helping get us out of this mess… this is what comes next.
There’s a lot to learn from looking at the list of countries who managed to secure significant doses of vaccine early in the game, because it begs a lot of questions. Why are they doing so well? Where did they get it from? Why did they get it and not us?
Starting at the top of the list and sorting by Doses… either by “population percentage with at least one dose” or simply “doses per 100 people” – the results are pretty much the same. There, it makes sense to remove the “big” names because the answer is obvious… those that are making the vaccines are using it for themselves as much as they can. The U.S., the U.K, China, Russia. Also remove from there places whose numbers are skewed because of low populations. The Maldives, the Seychelles… tiny populations, mostly vaccinated.
The top of the list now is of course Israel, who was on top of the list before anyone else was removed. They have a population of 9,000,000. They’ve administered 9,000,000 doses. They’re not all first doses, but most are. I saw a picture of a café in Tel Aviv yesterday… and outdoor patio, crowded, no masks, people having a blast. We’ll be there one day… but they’re there now.
How did Israel do it? A pretty sweet deal with Pfizer – one that worked out well for everyone. Lots of data, lots of healthy people. There are plenty of articles to read about how it all came about.
But who’s next on the list now? A terrific outlier to study, as far as I’m concerned.
Chile… and I’m interested because I was born there. Because I have friends and family there. Because I used to travel down there on an almost annual basis, and I know how things work; I know more about doing business with Chile than anyone would ever want to know… which led me to ask the relevant question… who’d they hustle and how’d they do it? Their population is about half of Canada. 22% of those people have had at least one dose. We’re at 5%.
May of 2020 was a bad month down there… 100,000 new infections and almost 1,000 deaths. That’s when they began taking their vaccine plan seriously. Their ministry of health set up meetings with 11 labs around the world, a number that went down to 5 as talks progressed. Internally, it was agreed that when the health regulators of those jurisdictions approved those vaccines, they’d be auto-approved in Chile. To lock in those supplies, meetings were scheduled *in person*. The Chileans flew out to numerous places, including Abu Dabi and the UAE, principal operational hubs for Pfizer and BioNTech. And this is where the Chilean way of business kicked in. I wasn’t in those rooms, but what I know is that those Chileans did not leave without firm deals to receive vaccine; letters of intent, confidentiality agreements… and, probably, agreements not so different from Israel – yes, for sure, we’ll give you the data… we’ll red-line vaccinations… whatever you need… just get us the stuff, AND, if *you* don’t comply with your end of it, there will be hell to pay, as enforced by whatever international laws apply.
I’m speculating a bit and drawing on my knowledge on how things work, and what sort of leverage (the only sort that could possibly be applied) might have worked… because it ultimately worked, and worked well. Very early in the game, Chile was already ahead. By September of last year, Chile was setting up clinical trials for Sinovac and Janssen. Some 3,000 Chileans happily volunteered between October and November. And, for doing so, Chile locked in a $14/dose cost of vaccine and top of the delivery schedule. Chile stuck to their end of it, and the manufacturers have stuck to theirs. Win-win.
Around here, we’re paying $35/dose, when we can get it. Yes, I know – we’ve all read the same news – we will get it all in due course, and just because we keep getting dropped down the list it doesn’t mean anything. Patience, etc. By the time our anger and head-shaking subsides, the pandemic will be over and we’ll have moved on and nobody will care. But allow me to put it in writing; our government let us down. Good intentions are not good enough. Intention to have enough vaccine in a timely manner. Intention to have an infrastructure for booking appointments. Getting up in front a podium and TV cameras isn’t worth anything if you don’t deliver. Nobody is interested in finger pointing and lame excuses, especially how it’s “out of our control”. Your job as our leaders is to find a way to put it into *your* control. Our control. Many governments around the world, with far less resources at their disposal, managed to navigate this process far better.
Ultimately, I’m familiar with the Canadian way of doing business too. The 300,000,000 doses we’ve procured – in the same way Seinfeld “procured” a car reservation in that famous episode – was done with lots of emails, phone calls, Zoom meetings. Whiteboards and PowerPoints. Lawyers and contracts and back-and-forth mark-ups, with nothing in there that could incur any liability. And with nothing to offer in return, very little teeth in those agreements. How can we be sure they’ll hold up their end? It doesn’t matter… and don’t worry about it because with all the “best efforts” language in there, we have zero recourse anyway. Let’s just hope for the best.
Chile started at the finish line. They simply asked, “What is the fastest way to get vaccines into the arms of our population?”… and assigned a group of intelligent resourceful people to just get it done. And they did. Pisco Sours all around. Salúd.
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A year ago today, a man who’d recently returned from Wuhan, China, wasn’t feeling well… and wound up at Toronto’s Sunnybrook Hospital, where he became Canada’s first test-positive C19 case.
Hearing that this morning made me think back… what was I doing at the time? Thanks to modern technology, it doesn’t take much to scroll back through recent history.
A year ago last night, I was at the Chan Centre watching my talented nephew, acting in a very engaging and entertaining theatre production. It was excellent, and so, appropriately, the venue was jammed.
A year ago today was a Saturday, and, at 10am, we were back at UBC — at TRIUMF this time — for a couple of lectures. One was about earthquakes – the famous impending “big one” that will hit the south coast, sometime between tonight and 500 years from now. The other was about black holes, cosmic collisions and sensing gravitational waves. Takeaway: If a large earthquake shows up off the south coast, don’t be in Tofino. And, I guess, if a black hole shows up off the south coast, don’t be in Tofino either… but you won’t have much too time to worry about it.
These lectures are super-interesting if you’re into this sort of thing, so, accordingly, it was crowded. Sold out in fact. So sold out we couldn’t get tickets online, and just crashed the venue, hoping we could sneak in. The tickets are free, but seating is limited; fortunately, some people didn’t show up and they let us in.
The kids were there too, and perhaps it took a bit of gentle bartering to get one of them there as well, because we wound up going out for dinner that night, to Kobe. Kobe is excellent, and always crowded as well; you end up sharing a table/cooking surface with complete strangers for a couple of hours.
Talk about taking stuff for granted. Three very different things, but all had one thing in common; hanging out in close proximity with strangers… and thinking nothing of it. That’s how it was.
So, what’s happened in that one year… today also marks another milestone; today, the world went over 100,000,000 known C19 cases. There have been over 2,000,000 deaths. There have also been over 72,000,000 recoveries. In Canada, more than 750,000 cases came after that guy.
My prediction was that here in Canada, we’d be seeing the worst of this pandemic… right about now. Now would be the time when the gradual decline would begin, and while it’d take a long time to snuff it out in due course, it’d never get worse than what we’re experiencing now.
This completely-non-professional opinion was based on the confluence of a few things, but primarily, it’s this: any negative effect that would’ve been caused by the holiday season would now be known and we’d be in the midst of handling. Whether they were supposed to or not, people got together over the holidays. Some of them passed on infections, etc… so how bad was it? Well, it definitely caused a spike, but if you look at the graphs and numbers, things are clearly trending favourably. Couple that with the fact that there are no large family-gathering-type holidays any time soon… and given that vaccines are every day making slow but steady progress into bloodstreams… and that the majority of people and businesses are still towing the party line… put it all together and, optimistically, the worst is behind us. That being said, who could’ve predicted newer mutations that are more virulent, and which could possibly lead to more cases. The answer to that question is epidemiologists… and they did.
We’re far from sounding the all-clear, but the numbers and pictures at the moment tell a cautiously-optimistic story; declines everywhere… ranging from steep (Alberta, Manitoba, Quebec) to moderate (B.C) to mild (Ontario, Saskatchewan)… but the entire country is trending in the right direction. For now.
Today’s versions of cool lectures, theatre productions, and restaurants look nothing like what they did a year ago. There are online and socially-distanced versions of all of that, but they’re nothing like the real thing. A year ago we had the real thing… and every indication is that a year from now, we’ll have it again.
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Nothing too exciting to report in the U.S. today – well, other than the revelation that the insurrectionists did indeed intend to take hostages and assassinate government officials. But other than that.
So… let’s get back to vaccines…
As promised, some Canadian jurisdictions have blown through their supplies, jabbing as many arms as they can, with the vast majority of those being first doses… many people having now decided that that’s the way to go – get it into as many people as possible, stretch the time frame a bit, and catch up in due course.
The advantage of that is that it maximises the number of people who are at least a bit immune, which is obviously better than nothing at all. If not being vaccinated is a 0 and being fully vaccinated and immunized is a 9.5 (there is no 10; there are no guarantees), it’s not like the first dose gets you to 2 or 3. Depends who you ask, it’s anywhere from a 5.2 to a 9.0… and then the second dose gets you up to 9.5.
That being the case, the right strategy for the big picture is to give everyone a first dose… and counting on getting the second dose in time. But don’t pick 50 people and give them both. Or don’t do it where 33 people get two, 33 people get one, and 33 get zero.
Here in B.C., we’ve administered 98% of the vaccine we’ve received, and the plan is in place to keep doing that; that we have the infrastructure to dish it out as fast as they can serve it to us, and that the limiting factor is supply. It should be noted that 100% of that 98% are first doses.
Interestingly, Alberta has administered 112% of their vaccine. They’ve received 74,000 doses from Pfizer and have injected 84,000 arms… also all first doses. How is that possible? Notwithstanding the fact that every vial of vaccine ostensibly ships with enough for 5 doses when thawed and diluted, doctors have found you can squeeze out perhaps 5.2 or 5.3… so 5 doses per vial might turn into 6 or even 7 after a while of collecting scraps. Pfizer has not said that’s ok, but they haven’t said it’s not. We’ve all scraped the bottom of the peanut-butter jar… with a spoon, with a finger, with whatever… because we all know there’s no difference in yumminess. Hopefully the vaccine is the same.
In Quebec, though… they may be stretching things a bit far. They’ve similarly administered 110% of their vaccine… but that’s not the issue; it’s not the extra doses they’re squeezing out… it’s that they’re aiming to measure those second-dose timings in months, not weeks… and the risk is that Pfizer pulls the plug on that. The province has said that of course they’ll follow those guidelines if it comes down to not getting the vaccine at all, but for now… they will pedal-to-the-metal red-line it while they can. And for the moment, 100% of that 110% has been first doses… over 127,000 of them. Why does this sound like it might be even remotely ok? Because there’s some British science to back it.
According to Pfizer, the vaccine is only 52% effective after the first dose. But according to British scientists, who are measuring the results differently, that number is 89%.
For comparison, according to Moderna, their vaccine is 80% effective after one dose, 96% after two…. and with respect to the CoronaVac vaccine developed by Sinovac in China… none of these results have been peer-reviewed and they’re all over the place, so hardly worth comparing… but here they are. The press releases from countries using it vary widely: Turkey says 91% effective… Indonesia 66%, Brazil 50%… and all of those results are based on the full two doses.
A few days ago, I wrote about this aspect of it, and was corrected by a few people… in my case, I was uneasy about B.C. stretching the dose-gap to 35 days. As I’ve learned, that’s no big deal. In fact, even though Pfizer has recommended 21 days for their vaccine, and Moderna 28 days for theirs… Canadian guidelines, ie the Federal Public Health Advisors have OK’d up to 42 days for both.
But, Quebec… 90 days. Three months instead of three weeks. Their argument for doing that? Well, see above. Good idea? Again, as per above… it’s a definite maybe.
Meanwhile, New Brunswick has administered around 8,000 doses, but 2,000 have been second doses. That being said, New Brunswick today had 25 new cases and zero deaths. Quebec had 1,918 new cases and 60 deaths. A very different sense of urgency.
Today we hear the dire projections from models that imply things could get a lot worse if we don’t clamp down… and immunizing as many people as possible in that scenario is the right call. About the only thing that could mess this up is if not enough vaccine shows up for those first doses (let alone the second).
Since early 2021 hasn’t completely let go of the 2020 shitshow quite yet, today we hear that there will be vaccine delays. To be sure, don’t worry, we’ll be able to catch up in due course, a minor hiccup, etc… but of course, the issue is that we need them now. We’ve been assured that the timeline to get everyone vaccinated by the end of the year is not in jeopardy… and I believe it, especially given the quantity of vaccine Canada has procured… 10 doses for every person, specifically to mitigate this sort of situation. But it’s the bird-in-hand vs. birds-in-the-bush situation… I’d rather have one rickety old fire engine show up quickly… than five glistening bright-red new ones after everything has already burned down.
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