Managing vaccines is going to be hard. Managing expectations may be even harder

OPINION: We know enough to sketch out what Ontario’s vaccination plan will look like — we also need to accept that it’s not going to turn off the pandemic like a light switch
By John Michael McGrath - Published on Dec 04, 2020
The Ontario government announced the members of its COVID-19 vaccine panel on December 4. (iStock/Geber86)



The federal government is taking incoming fire over its handling of COVID-19 vaccine procurement, both from across the aisles in the House of Commons and from across the federal/provincial divide, as provincial premiers, including Ontario’s Doug Ford, demand more clarity about how much vaccine and what variants will be made available, and when. It’s fair for the provincial government — which will, in the end, bear final responsibility for getting needles in arms — to want as much clarity as possible. But in the last week or so, enough has become clear that those of us outside of government can sketch out much of what the few months of 2021 will look like.

For argument’s sake, let’s take the following as given: sufficient vaccines for roughly 3 million people will arrive in Canada by the end of March and will be distributed to the provinces with, one hopes, the minimum of logistical foul-ups. It might be better (we could end up receiving more vaccines than currently announced), or it might be worse (it’s honestly slightly worrying that our pandemic response is going to depend in no small part on the condition of Canadian highways in January and February). If Ontario gets its customary 40 per cent of the available vaccines, that means 1.2 million residents of this province could be protected by late March or early April.

But these vaccinations aren’t going to be distributed randomly: they’ll go to the people most at risk of death from COVID-19 first, including long-term-care residents, people in retirement homes, and the workers in those places and in the health-care sector. (Thanks to the Globe and Mail’s Kelly Grant, who did the math last month on how much of the province’s most at-risk could be covered.)

Careful observers will note that 1.2 million is less than 10 per cent of Ontario’s overall population, and that’s a large part of why Prime Minister Justin Trudeau is taking heat over vaccine procurement: it seems likely that Canada won’t have sufficient vaccines to inoculate the majority of the population until later in 2021.

But we also shouldn’t discount how important it will be to get the most vulnerable populations vaccinated early. The most obvious result would be a very substantial reduction in the number of deaths from COVID-19 once the oldest, frailest people are protected. In both the first and second waves of the pandemic, deaths have been concentrated (although not exclusively) in long-term care and in people over the age of 70. So it’s actually a reasonable expectation that, by the spring, we could see dramatically fewer deaths — even while the vast majority of the population would still be unprotected.

But fewer deaths won’t necessarily mean fewer illnesses or fewer hospitalizations. And some of the pillars of the government’s pandemic response will still be operative: the province is going to want to avoid overtaxing the health-care system and to keep schools open.

Neither of those goals is possible if the pandemic is allowed to run wild — even if nobody dies from COVID-19. Sick people who avoid death can still take up hospital beds, and enough sick people can still send students and teachers home from school.

Schools, in particular, are going to be an open question for some time to come, since neither of the two vaccines expected to arrive shortly have been approved for use in children yet. Teachers might get vaccinated, at least before next fall, but we have nothing so far to inform a guess about whether children will be vaccinated before the next school year starts in September 2021.

It is still true and correct that vaccinations will be how we get life back to normal. But even as deaths fall from the first tranche of vaccinations, we won’t be able to turn off the public-health measures we’re living under as if they were a light switch. The public is going to need to be patient, and the businesses that have struggled with various levels of restrictions may be asked to endure them for longer than seems obviously necessary.

The experience of the last few months — during which the government struggled to rebuff special pleading from retailers and restaurateurs even as cases and deaths started to soar — is a cautionary tale. Businesses are going to be no less anxious to throw off public-health measures in March or April than they are now, and they’ll be able to point to falling deaths as an argument for a return to normalcy.

But both business and government are going to need to be very careful not to chase a mirage in the desert: if a large enough share of the population hasn’t yet been vaccinated, reopening too much, too soon in the spring could lead to the disaster we spend all summer trying to contain.

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