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June 30, 2021 - Dr. Archer's Update on COVID-19 response from the DOM and Medicine Program

Headlines

Stage 2 reopening in Ontario: Effective today, Ontario has entered Stage 2 of the re-opening after the 3rd wave COVID-19 lockdown. This does not mean masks will disappear in indoor spaces; however, a lot of things will become easier and more enjoyable (click here). Whether you are looking forward to a haircut, playing baseball or soccer, or just getting together with friends for a BBQ, Stage 2 is welcome. To ensure we reach Stage 3 of reopening and avoid a 4th wave of COVID-19, we (all Canadians) will need to continue our drive to achieve universal vaccination, overcoming vaccine hesitancy, and support/drive our government’s participation in efforts to achieve global access to vaccination. Despite the fact that there is more to be done before we can declare the pandemic over, this stage of reopening is a welcome and positive moment!

photo of Kingston City Hall

1) Vaccine passport challenges and the European Union’s Green Pass-Why Covishield (made in India’s Serum Institute) is not eligible whilst the Astra Zeneca vaccine (the same product form a different manufacturer) is eligible (click here).

2) KFL&A update: 3rd wave resolving locally (3 patients in KGH), 4 local active cases, and 77% of eligible residents (12-years and older) vaccinated at least once and 36.6% fully vaccinated (see update from KFL&A Public Health).

3) Wave 3 subsides as Ontario exceeds vaccine targets and infection rates fall (299 new cases yesterday and a 1.6% positive COVID-19 test rate) (click here(click here): an accelerated move to stage 2 reopening begins today (click here). 

4) Canada’s COVID-19 epidemic rapidly resolving with > 36.7 million doses of vaccines administered: New and active cases (down -26% and -27%, respectively), hospitalizations falling (-13%) and deaths down to 35 people yesterday (click here) (click here).

5) World vaccine roll-out tops 3 billion people (click here): but it is mainly rich countries benefiting.

6) The global pandemic: ~181.9 million cases and 3,940,043 deaths to date click here.

 

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1) Vaccine passport challenges and the European Union’s Green Pass-Why Covishield (made in India’s Serum Institute) is not (yet) eligible whilst the Astra Zeneca vaccine (which is the same product form a different manufacturer) is eligible (click here).

The European Union is far ahead of Canada in dealing with travel during the COVID-19 year. They have created an EU Digital COVID Certificate, popularly called the Green Pass, “to ensure that restrictions currently in place can be lifted in a coordinated manner, it is digital proof that a person has either been vaccinated against COVID-19, or received a negative test result, or recovered from the viral infection.” This COVID certificate is valid in all EU countries. The EU is launching a vaccine passport system coming into effect across EU on July 1, 2021. However there is a catch. To get the fast-track treatment upon arriving in an EU country, your vaccine has to be on the European Medical Agency (EMA) list of approved vaccines. Approval takes into account the manufacturing process and facility-not just the product itself (read about Health Canada’s process for vaccine approval here). Currently the EU list only includes: Vaxzevria (Oxford-AstraZeneca), Comirnaty (Pfizer-BioNTech), Spikevax (Moderna) and Janssen (Johnson & Johnson).

Relevant to people around the world, including some Canadians, the Green Pass list does not include Covishield, Covaxin or Sputnik V. In the case of Covishield this at first appears hard to understand. This is the same adenoviral vaccine made in England by Astra Zeneca (and Oxford University). Covishield is the same vaccine made by Astra Zeneca; however it is produced by the Serum Institute of India; not in England. The real problem however is that he Serum Institute of India has not applied for Covishield’s approval by the EMA. If a company wants its vaccine to be valid for inclusion in the Green Pass program they have to submit the required documents to the EMA for approval. Until the Serum Institute of India submits these documents (and receives approval) people traveling form India, Africa and potentially Canada will be inconvenienced. While you don’t have to have a Green Pass to visit the EU it speeds up entry. The Serum Institute of India’s CEO Adar Poonawalla indicates he is aware and taking action to correct the situation, tweeting, “I realize that a lot of Indians who have taken COVISHIELD are facing issues with travel to the E.U., I assure everyone, I have taken this up at the highest levels and hope to resolve this matter soon, both with regulators and at a diplomatic level with countries.”

Vaccine passports remain controversial for legitimate reasons (like the lack of universal access to vaccines for people willing to be vaccinated). However, as we make vaccine available globally and everyone can have a vaccine that wants one, passports will likely happen. Indeed, requirements for vaccination are already in place in Canada. Travelling to Prince Edward Island requires proof of vaccination. Some people are even requiring their wedding guests to be vaccinated(that could make for some truly memorable receptions!). However, to ensure vaccine passports don’t backfire the mundane but important act of global regulatory agencies, like the EMA, FDA and Health Canada, certifying all effective vaccines needs to happen post haste!

2) KFL&A update: 3rd wave resolving locally (3 patients in KGH), 4 local active cases, and 77% of eligible residents (12-years and older) vaccinated at least once and 36.6% fully vaccinated (see update from KFL& A Public Health)

The 3rd wave of COVID-19 has largely resolved in SE Ontario. Since the pandemic began we have had 1557, cases in KFL&A, not counting the resolved prison outbreak or people from other regions (see below). There has been only 1 new case in the past week and there are only 4 active local cases. This and the high vaccination rate (77%) allowed an accelerate Stage 2 reopening (see below).

table with numbers and graphs showing current data in phase three of vaccination in KFLA

Vaccination rates in KFL&A, June 30th 2021

The Medicine program remains extremely busy with non-COVID-19 care. We are looking after >182 patients at KHSC and run an additional ward at HDH. We are ramping up clinics toward pre-pandemic levels (although volumes will still be limited by the size of waiting rooms and ongoing masking/physical distancing requirements).

3) Wave 3 continues to subside as Ontario exceeds vaccine targets and infection rates fall with 299 new cases yesterday and a 1.6% positive COVID-19 test rate (click here(click here): an accelerated move to stage 2 reopening begins today (click here

Ontario has made amazing progress toward quashing wave 3. The rates of new and active cases are down 17 and 26% respectively in the past week. 9.75 million Ontarians have had at least 1 vaccine dose and 3.3 million are fully vaccinated. 

graphs and text boxes with data for current Ontario covid situation

Wave 3 resolving in Ontario, June 30th 2021

Stage 2 reopening allows (click here): (let’s begin with haircuts)!

  • indoor, masked social gatherings of up to 5 people.
  • up to 25 people would be able to attend outdoor functions.
  • as many as 6 people could dine together on a patio.
  • Personal care services like hair stylists and nail salons would also reopen, as long as masks are worn at all times.
  • capacity limits on essential retail will increase to 50 %.
  • non-essential retail capacity will increase to 25 %.

4) Canada’s COVID-19 epidemic rapidly resolving with > 36.7 million doses of vaccines administered: New and active cases (down -26% and -27%, respectively), hospitalizations falling (-13%) and deaths down to 35 people yesterday (click here) (click here).

map of Canada and the surrounding waterssalmon coloured bar graph and text boxes showing current covid data for Canada

Resolution of Wave 3 in Canada June 30th, 2021

New and active case rates are falling rapidly and hospitalizations declining in Canada (see above). We have had 1.414 million cases of COVID-19 since the pandemic began. The case mortality rate remains at 1.45% with 26,273 deaths (up 92 from last Thursday, see below). We have done 37.3 million COVID-19 tests (with a cumulative positive rate of 3.79%). We have administered a cumulative 36.7 million COVID-19 vaccinations. Hospitalizations are also declining (falling below 1000 people for the first time this week, with 827 people in hospital today).

various types of graphs outlining current data re the covid pandemic in Canada

COVID-19 vaccinations rising and hospitalizations falling across Canada June 30th 2021

Canada becomes a vaccine success story: 67% of Canadians have had at least one shot and 29.1% are fully vaccinated! 36 million doses have been administered (click here): To date, 44 million doses of COVID-19 vaccines have been delivered but only 82% of delivered doses have been administered. 575,886 people were vaccinated yesterday (the highest daily total I have seen so far and up ~200,000 from last week’s daily high). Canada is near the top of the pack in vaccines administered per day now! The graph below shows the rate of vaccination per 100 people yesterday, June 29th (see below).

colourful horizontal bar graphs

5) World vaccine roll-out tops 3 billion people (click here): but it is mainly rich countries benefiting.

colourful horizontal bar graphs

3 billion vaccines administered!

Vaccines are the key to ending COVID-19; however, low-income countries remain vaccine deserts. The entire continent of Africa remains a vaccine desert.

colourful wave type graph

COVID-19 Vaccines remain rare in Africa (click here), June 30th 2021 

Progress in vaccine administration largely applies to wealthy countries. This is not only unjust; it also allows for the creation and spread of new viral mutants, like the Delta variant, which are more infectious and may lead to immune evasion, thereby keeping the pandemic going. Both the USA (click here) and Canada (click here) have committed to sharing vaccines abroad by the end of 2021.

6) The global pandemic: ~181.9 million cases and 3,940,043 deaths to date click here.

satelite image of earth taken from space

We have been fortunate throughout the pandemic to benefit from the on-line data display tool provided by Johns Hopkins University. Here is today’s map of the global pandemic. That is good news with daily cases falling (red graph) and deaths in decline (white graph) and vaccine on the rise (green graph). There are several caveats! First, in some countries the accuracy of case counts and death rates is uncertain. India recently acknowledged a serious undercounting of deaths.

world map with yellow dots and graphs

Global COVID-19, June 30th 2021

Second rates of new infection are on the rise in many parts of Africa and South America (see map below).

world map with various sizes of blue dots

We are not all in the same boat: COVID-19 hot spots in India, South America and Africa (the bigger the blue circle the more cases)-the medium sized blue circles indicate 400,000 cases.

COVID-19 Vaccine FAQs and report on Long Term Care Facilities are on hiatus (no updates of significance).

 

Stay Well! …. Get Vaccinated!!! Wishing you a happy and healthy Canada Day weekend!

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