VIdeo – HKPR District Health Unit – Alderville Can Expect Steep Increase in Vaccines

By Cecilia Nasmith/Today’s Northumberland

Alderville First Nation Chief Dave Mowat may feel his community is being slighted now in terms of vaccine response, but Haliburton Kawartha Pine Ridge District Health Unit Medical Officer of Health Dr. Ian Gemmill offered reassuring words at this week’s media scrum.

An e-mail Mowat sent to a number of people – including the Northumberland-Peterborough South MP and MPP, and also Dr. Gemmill – pointed out that only 10 of the 12,000 doses the health unit has received were dispensed in Alderville.

By his calculations, that amounts to one in every 1,200 doses, or less than 1%.

Meanwhile, Mowat said, Alderville has had three cases and there’s no reason to think there may not be more.

“I just spoke with (Hiawatha First Nation) Chief Laurie Carr and I know their entire community will be vaccinated March 13/14th. So what gives?” he asked.

“I have some frail elders living here, still independently and I cannot accept a 1 in 1200 ratio.”

Dr. Gemmill said the Alderville residents inoculated were in a high-risk retirement home. These individuals rank high on the list of priorities set by the province, and their counterparts elsewhere in Northumberland also were first in line.

They are moving on to long-term-care staff and essential caregivers, then certain first responders and highest-risk health-care workers.

Dr. Gemmill said Alderville should see a significant shift, however, at such time as they are taken care of and vaccinations filter down to more of the general community.

“I can assure you, Alderville has not been forgotten,” he said.

“We will provide that community with as much vaccine as they can manage.”

Dr. Gemmill noted that the population of that community accounts for only about 500 of the Northumberland County’s 80,000 people, and said his staff have worked with them in preparation for this particular time as the priority populations are completed and more people in the community become eligible – at which point, he said, “they will be way ahead of the rest of the population.”

And it’s only a matter of days or weeks, he added, before they get enough to vaccinate the entire community.

“They will get the vaccine before our 80-year-olds and the rest of the population,” he said.

While a region-wide “significant” fall in new COVID-19 cases is reason to celebrate, Dr. Gemmill continues to urge everyone to stay home and follow masking, distancing and other protocols until another number comes down.

“Ninety-eight per cent of our population is not protected, either by having had the disease or being immunized yet, so we still have a lot of susceptible people out there.”

The significant fall Dr. Gemmill referred to is the region’s 52 new cases over the previous 14 days, compared to 114 last week.

“That means just over four cases per day,” he said.

It was pointed out that the County of Haliburton (one of the health unit’s three counties) has had no cases at all for the past two weeks.

“Things are getting better, and I am really pleased about that,” he added.

Possible reasons for the improvement, he conjectured, might be a holdover from recent restrictions that have been lifted, or it may be a natural development as winter begins to fade, or it could reflect the current lack of long-term-care home outbreaks as these residents complete their course of vaccinations.

Locally, most long-term-care residents have had both doses, and a start has been made on their staff and essential care givers, along with high-risk health-care workers and Alderville First Nation residents.

At any rate, he characterizes the light at the end of the tunnel that vaccines provide as more of a floodlight.

The approval of the refrigerator-safe AstraZeneca vaccine as “a big, euphoric moment.” Unfortunately, the news soon followed that the National Advisory Committee on Immunization suggested the vaccine should not be given to anyone over the age of 65.

This is based on the fact that – unlike Pfizer and Moderna – AstraZeneca failed to include anyone of that age in its clinical trials so more data are needed on its effectiveness in that age group. Without that data, he said, NACI urges erring on the side of caution.

Fortunately that information should be coming soon, as the United Kingdom is using Astra Zeneca on citizens of all ages, so this decision may ultimately be revisited. Until that happens, the province is recommending Astra Zeneca only for those under age 65.

“It’s a provincial decision, and locally we do not have control,” Dr. Gemmill said.
Meanwhile, he said this complication may ultimately alter the phase-in based on age for people in the community to have their turn at the shots, depending on supply.

This too is a provincial call, with allocations based on two considerations – a region’s population and the acuteness of its COVID situation. As an orange zone with a relatively low population and a case count that was also relatively low, the HKPR region is not high on their priority list.

To date, the region has received some 12,000 doses – “not enough for those highest-priority groups, but we are working through them,” Dr. Gemmill said.

“Older people living in the community or on home care, stay tuned. It could be very soon, because things are changing all the time and we will be using any opportunity we have to get that vaccine into arms – even if it’s not quite in the priority list – just so we can use the vaccine and get more people protected.”

For example, Northumberland Paramedics Chief Susan Brown said this week that some of her crew are getting their first shots simply from assisting at some vaccination events where there have proven to be surplus shots available.
“We want to use the vaccine in the best and quickest way possible,” the doctor stated.

Dr. Gemmill gets constant questions – and so do some of our local hospitals, he noted – from people eager to book appointments. The region will be part of the provincial vaccination registration online site that will open March 15 (and which will include the capacity to make appointments by phone for those without internet accessibility and/or expertise). As supplies increase enough to begin establishing community-based clinics, these will be programmed into the provincial system and made available to qualifying local residents.

Dr. Gemmill said that news that some other provinces are allowing 16 weeks between first and second doses should not be of concern.

“Instead of saving a vaccine for a second dose for people who already have some protection, we can get more first doses into people which, from a disease-control point of view, makes a lot of sense,” he explained.

The recommendations for a 21-day interim period from Pfizer and a 28-day period from Moderna were based simply on the fact that this is the interval they used in their clinical trials. Dr. Gemmill’s own experience is that he never saw a problem from extending interval times – whereas shortening them actually wastes vaccine, since the second dose comes before the first dose can complete its work.

How that work proceeds is something we still don’t know enough about that he could answer a reporter’s question on whether we can hug our elderly parents and grandparents. While he wouldn’t say yes or no, he would say “soon.”

The organizing of community vaccination clinics is going on and – though he is not ready to reveal specific locations – he said there will be at least two in each of the region’s three counties, geographically separated to be accessible to as many people as possible.

In addition, they have family doctors, family health teams and community health centres on board, with the aim of providing as many opportunities for vaccination as possible.

There are plans to redeploy and even hire additional people to provide the inoculations, although certain roles could be managed by volunteers.

“We don’t need a nurse to greet people at the door. We don’t need a nurse to check that the patients have the necessary identification,” he said.

“It will be a combination.”

Meanwhile, variants remain a concern. There are 14 region-wide, all but a couple of them in Northumberland County.

“This is just a reflection of what’s going to happen right across Ontario,” Dr. Gemmill said.

“I am quite concerned and that is why, even though a vaccine is going out the door, I continue to advise people to be cautious, to wait to hug their grandparents.”