The Doug Ford government faces a real dilemma as the province proceeds to the second phase of its vaccination campaign: continue to focus on people over the age of 60, who have made up the vast majority of COVID-19 deaths, or shift some of its efforts to offer greater protections to people working in essential industries. The plan presented to the public Tuesday makes it clear that the province is going to try to do both — but not at the same time, potentially leaving vulnerable workers unprotected until the middle of May.
Government officials defended the plan by saying that vaccine supply is still limited and that priority has to go to the people most risk of dying from the virus. The headline numbers here are unambiguous: more than 95 per cent of people who have died from COVID-19 were aged 60 or over, and the province still hasn’t finished the job of vaccinating everyone above that age cutoff. The horrifying reality is that, although many vaccines have arrived in recent days, the government still needs to pick and choose who gets a shot first, and the consequences for choosing badly could be that people die unnecessarily.
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I’m sympathetic to the government’s dilemma here, and I don’t think that the members of the vaccine task force are taking their jobs lightly when they make these decisions. But there’s another argument being made in increasingly vocal ways by health-care workers individually and by groups up to and including the Ontario Medical Association: that it’s time for the government to focus vaccinations on essential workers.
“More than 3,000 Ontarians are contracting COVID-19 every day. Most of them are essential workers, catching the virus on the job,” reads a Monday release from the OMA. “More and more infected people are bringing the virus home, and doctors are seeing entire families being infected. The new variants of COVID are striking younger people, who are being hospitalized and admitted to intensive care units at alarming rates.”
(The OMA is also calling for a more rigorous provincial stay-at-home order in lieu of the extremely porous “shutdown” the government announced last week; the premier hinted that more restrictions will be coming Wednesday for at least some GTA municipalities.)
The argument for vaccinating essential workers is almost as clear-cut as the argument for vaccinating seniors: whatever the relative risks to people over the age of 60, in the real world, it’s people working in essential workplaces who are getting and spreading this disease — people who don’t have the luxury of working from home while they prepare and process the groceries and Amazon deliveries the rest of us rely on.
And this is the critical point: we aren’t keeping seniors safe by letting this pandemic tear through essential workplaces like wildfire, either. The clusters of infection in Peel and Toronto are generating cases of COVID-19 disproportionate to their total population, as they have throughout the pandemic. And just because a chain of infection starts at a fulfilment centre in Brampton doesn’t mean it will end there. Or even nearby.
That’s the dilemma, in a nutshell: If a worker in their 30s could get sick and bring the virus to their grandparent, which of them should be getting the vaccine? The mandate to stop deaths says the grandparent; the objective of stopping transmission suggests the worker.
We’ve largely failed to protect essential workers throughout the pandemic — mostly notably, the Ontario government has refused to offer them any kind of paid sick leave. Even if you’re skeptical about the value of paid sick leave, the government’s other efforts, such as workplace inspections, haven’t been an obvious success; some facilities have received multiple apparently ineffectual orders from the Ministry of Labour and then been closed by local public-health orders. This is offensive, but then so much about the pandemic is offensive. The more important issue is whether the current vaccination priority is doing what we’re trying to do: protect people from dying of this disease.
It’s possible that local medical officers of health will start deviating from provincial direction — indeed, we’ve already seen reports that Niagara Public Health is going to vaccinate 4,000 education workers before the end of the spring break, even though they’re not that high on the province’s priority list. It’s possible that Peel and Toronto’s medical officers of health could do the same thing, and then it would be up to the province — specifically, Ford and his cabinet — whether to put its foot down and insist on adherence to the provincial priority list.