Transcript: Ep. 108 - Are vaccines languishing in freezers? | Apr 20, 2021

STEVE:
Welcome, everyone,
to the OnPoli Podcast.
I'm Steve Paikin.
JOHN MICHAEL:
And I'm John Michael McGrath.
STEVE:
The news around
this third wave of the pandemic
just seems to be
getting worse and worse.
The province has announced that
COVID-19 cases,
hospitalizations,
and intensive
care unit occupancy
are at their highest levels
since the coronavirus
became part of our daily lives.
As a result, the lockdown
will last another two weeks
beyond what was already planned.
Meanwhile,
some of what was planned
has already been jettisoned,
as many in the province mutinied
against what they saw
as nonsensical measures.
All that, plus an interview
with a member of the province's
Vaccine Distribution Task Force
to fact check whether doses
really are sitting in freezers
instead of
getting into people's arms.
It's Tuesday,
April 20th, 2021.
So let's get to it.

STEVE:
John Michael, we got new
modelling numbers last Friday,
and sadly,
they are off the charts.
Well, actually,
let me rephrase that.
They're on the charts,
but they're near
the top of those charts.
So, let's start there.
What were the major takeaways
from
the health table's briefing?
JOHN MICHAEL:
The short version is that
the province's
intensive care units
are almost
at the breaking point.
And, unless
something changes quickly,
doctors are going
to need to start doing
what we thought we had avoided
in the first and second waves:
determining who gets
access to hospital healthcare
and who doesn't.
And, we know that when
we have insufficient numbers
of ICU beds to go around
for the number of
COVID patients that we have...
We saw this experience
in other countries
in the first wave
of the pandemic.
The death toll
can get much, much higher.
That doesn't even get to
the issue of non-COVID patients
who can't get
into a hospital right now.
We don't know what
the death toll from that is.
We know that it's not zero.
Um, and to top it all off,
the projections that
the modelling table presented
show that
vaccinations aren't the key
to get
out of this wave right now.
This has been true before,
in previous presentations.
They put a bit
of a finer point on it,
uh, last week,
saying that, you know, the...
Even really
optimistic projections
of vaccine through-put
don't do as much as public
health measures can right now.
We have to rely on stronger
public health measures.
And, you know,
presented with this,
you know,
testimony, I guess,
from the Science Table,
the government then,
on Friday afternoon,
announced
new public health measures,
though, their relationship
to the scientific advice
they got is a question.
(Laughing)
STEVE:
A question is
a gentle way of putting it.
Let's just recap here.
We have been told that
the two really safest places
you can be right now are:
kind of alone at home,
or at home with
just the bubble of people
that you have been
with for the last year,
or conversely, outdoors,
where the virus is not
as catching, obviously,
as it is in other
congregate care settings
and so on.
So, when the government
did announce on Friday,
that golf courses,
and soccer pitches,
and outdoor tennis courts,
and playgrounds,
would all be closed
and off limits,
well, people raised
H-E-double hockey sticks
all over the place,
and the government relented.
Why don't you just
take us through that?
What happened there?
JOHN MICHAEL:
The government made
this announcement on Friday
that they were closing
all of these outdoor amenities.
And, um...
(Laughing)
I guess as a journalist
it's not... it's not great
to sort of disclose
that I was furious
at the announcement that
they were closing playgrounds,
because, I have
a young child,
and literally,
bringing her to playgrounds
is one of the only things
that has kept her and I
both sane in the last year.
Um, but--
STEVE:
I thought I was
helping keep you sane.
(Both laughing)
JOHN MICHAEL:
You and my child.
STEVE:
Thank you.
Thank you.
JOHN MICHAEL:
Um, so, you know,
parents were furious.
And, you know, all of
these other outdoor amenities...
You know, there are people
who have been, you know,
helping their own mental health
by playing tennis, by,
you know, playing golf,
by running around
in soccer pitches.
You know, these...
And all of those outdoor
amenities by the way,
aside from
children's playgrounds,
those are all still closed
under the current
stay-at-home order.
The government says that it
was trying to reduce mobility.
And it is true and correct
that we are trying
to reduce mobility overall
to reduce
the spread of COVID-19.
But, it honestly
doesn't make a lot of sense
for the government
on the one hand
to tell people to, you know,
"Stay out of outdoor spaces,"
while they, frankly,
didn't announce
very much at all
that was new about the places
where we know
COVID is spreading.
And that's workplaces.
That's, you know,
essential workplaces
where people
cannot work from home,
where, you know,
people are in,
for example,
in Amazon warehouses,
or slaughterhouses,
where people are working
in cramped conditions
with less than medically
ideal levels of ventilation.
So, none of it
seemed to be actually based on
the scientific advice that
the government had received.
And in fact,
members of the Science Table
have spoken publically
to the media
in the last several days
about how the government is not
following their advice, and,
more than one have said
they considered
resigning in protest over it.
STEVE:
Yeah, let me follow up on that.
I did notice those comments
as well in the media, and, um.
I wonder, I mean,
people in this position
always have
to face two prospects.
Number one, you resign, which
is a good headline for a day,
and it does indicate a lack
of confidence in the government,
but then, of course,
they appoint somebody else
to take your position.
And therefore,
the person who replaces you
may not have your expertise,
may not be prepared
to speak truth to power,
may be telling the government
only what they wanna hear.
And therefore, your resignation
may not have achieved anything
at the end of the day.
I guess that's
what all of these people
who are on the Science Table
are pondering right now, right?
How can they best be of service,
either by resigning
and causing a kerfuffle,
or staying in there and hoping
they can convince the government
to do what they think
is the best thing to do?
JOHN MICHAEL:
I don't envy them the dilemma,
because, on the one hand
you have to think about...
And, you know,
these are professionals
in the sort of "capital P"
profession sense of the word.
They actually have to think hard
about
their professional reputation.
And, it is not helping anybody
if they stay with a government
that is really, visibly,
publically ignoring
their advice.
At the same time, it is also...
Frankly, it is an open question
as to whether
the Science Table...
If, for example, if they
resigned en masse in protest,
who would replace them?
Would they even be replaced?
I mean, there's no shortage of,
you know, advice coming
to the government right now.
And frankly,
the Science Table...
The government could simply
decide not to replace them.
And that would, arguably,
be the worst outcome.
So, yeah, it is absolutely
a really tough decision.
And, Lord knows,
I'm not in a position
to tell them what
the right decision to make is.
STEVE:
No, but many
Ontarians felt they were,
and that was one of the things
that was so interesting
about the past weekend,
was that
the government's directives
for so many Ontarians
seem to go against
what the facts were suggesting.
As we have said, the safest
place to be during the pandemic,
besides alone at home,
is outdoors.
And yet,
they wanted to shut down...
Well, let me
colloquially put this.
They wanted
to shut down outdoors.
Conversely, some of the most
virulent hotspots for COVID
are the big manufacturing
and employment spots,
as you pointed out.
And yet, they're
still allowed to be open.
And there has been still no move
to implement a comprehensive
paid sick days plan,
which everybody is calling for,
including,
on
The Agenda
last week,
The Ontario Chamber of Commerce,
who said they're open to having
that kind of plan in place.
So, okay, JMM, you make sense
of all of that for us, please.
JOHN MICHAEL:
Uh, honestly, I cannot.
I haven't covered as many
governments at Queen's Park
as you have.
I have just covered, really,
the one, Kathleen Wynne's.
And, you know, I was willing and
ready to criticize the Liberals
when I thought
they were making errors,
or when I thought
they were misleading the public,
but, never for a minute
did I think that Kathleen Wynne
simply didn't grasp
the nature of the problems
her government faced.
Um, the decisions that this
government announced on Friday,
and then, only partially
reversed over the weekend,
leave me actually wondering
whether a year
into this pandemic,
"Do they actually understand
the contours of the problem?"
Like, I don't understand
how you announce prohibitions
on outdoor activity,
while keeping
every single workplace,
that the government has
previously deemed essential,
open.
Uh...
(Stammering)
It feels like they
just do not understand it.
And that's a really
alarming place to be right now.
STEVE:
Well, let me pursue
another angle with you,
'cause I found another thing
particularly fascinating
about the response
to the latest directives,
and that was that even
police services across Ontario
balked
at implementing the measures
that the government introduced.
For example,
the Solicitor General
talked about giving cops
the right to inflict
$750 citations on citizens
who were
outside their homes without,
in the view of the government,
good reason, quote unquote.
And almost immediately,
at first a trickle,
but then
dozens of police services
went on record as saying,
"That may be the new policy,
but we are not
going to implement it."
I mean, imagine that!
Police services basically
said to the elected government
of the day,
"We are not going to do that."
And the government
then backed down, sort of.
What happened there?
JOHN MICHAEL:
It seems to have been
a bridge too far
for basically everyone.
The infringement
of people's civil liberties.
You know, I shouldn't
make a joke like this,
but, you know,
a cynic would say, "My God!
If you found
the charter infringement
that not even
the police will support!"
(Laughing)
Uh, the Canadian
Civil Liberties Association
was gonna fight it in court.
They called it Black Friday.
You know,
these are measures that we have
seen in some European countries.
We have not tried them in
Ontario to this extent before.
There seems to be no appetite
for it in the general populous,
no appetite
from the police to enforce it.
And, I think
this is the important part.
The government
was asking private citizens
to bear
all the pain here, right?
And this goes back to
what we were talking about:
paid sick leave, and
you know, essential workplaces.
You know, it is one thing to ask
citizens to bear this burden
because it is a grim necessity.
And it is another to say
that the public is going
to bear all of this burden,
but that Amazon warehouses
and condo construction sites
can still buzz along happily.
Um, they were asking too much,
I think, of the public,
and not asking enough of
other parties in this pandemic.
STEVE:
Hm, let's just take 20 seconds
here and remind people
that you and I have both written
columns about this issue,
and the last, well,
whatever, 72 or 90 hours, or so,
in the province of Ontario.
The gist of my column is that
democracy kind of worked here.
The government made a decision.
The public rose up in anger.
And the government
kind of backed down a bit.
That's sort of how
democracy is supposed to work.
A government
responsive to the public.
What's the nature
of the piece you wrote?
JOHN MICHAEL:
My piece is basically
wondering how angry
the Tory back bench
is right now.
You know,
there's clearly a lot of anger
outside of the PC Party,
and the back benchers inside
the PC Party, who, you know,
don't sit in Cabinet
but have to defend a lot
of the government's decisions.
I think, you know,
it's gonna be interesting
in the next week to see whether
they use some of
the leverage they have.
STEVE:
We are gonna
return to this issue
of whether there is discontent,
or how much there is,
on the back benches
of the PC Party,
a little later in the podcast.
But let's move now and look
at the vaccination situation.
Because on Friday, the Premier
said that he's waiting on NACI,
N-A-C-I, the National Advisory
Committee on Immunization,
to change the recommendation
on AstraZeneca.
And then, Sunday evening,
the province announced
that they are
lowering the age to 40
in which you can be
eligible to get the AZ shot.
Even though there was
not yet a new recommendation
from NACI on that.
Okay, JMM,
that's another good acronym.
JMM.
What happened there?
JOHN MICHAEL:
Well, I mean, obviously,
the most important element
of this news is that,
I, personally,
John Michael McGrath,
am now eligible
to get an AstraZeneca shot.
STEVE:
Congratulations.
JOHN MICHAEL:
So, and I will be working
to do that this week.
Um, no, what happened here
is that Health Canada
actually has
the legal regulatory power
over, you know,
how it is legal to administer
vaccines in Canada.
NACI is an advisory body
that both the federal,
and provincial
governments obviously,
give a lot of respect
to their recommendations.
People might remember earlier
in the pandemic when we...
Basically, all the provinces
have spaced out the intervals
between the two shots
that people are supposed to get.
They were waiting
for NACI advice to do that.
When they got it they moved.
This was starting
to get more pressing
because AstraZeneca vaccines
were starting to stock up
in provincial fridges,
so to speak.
Certainly in Ontario
that was the case.
NACI was recommending that
we limit the use of AstraZeneca
to people 55 and over.
But, in Ontario, anyway,
so many people who are
55 and over are already eligible
for the Pfizer
and Moderna doses.
And so, they were
preferring those vaccines.
And, AstraZeneca
was sitting around unused.
So, in order to basically
clear out this inventory...
And, like, these vaccines, they
do have expiry dates on them.
Um, Ontario, and now,
numerous other provinces have
announced that people 40 and up
will be eligible
for AstraZeneca.
And, you know,
I guess we will see that last
until supplies run out,
Because that's
the other catch in all this.
At least so far, we haven't
really gotten a regular,
consistent supply
of AstraZeneca so far.
STEVE:
Let's also note that, um...
Now, this was
kind of unusual I think.
The province said
it's looking at bringing in
extra healthcare staff
from other provinces,
or even from the United States.
And we saw something about
the Premier of Newfoundland,
whose wife is in healthcare.
She was offering her services
to the province of Ontario.
What are the prospects
of any of that happening?
JOHN MICHAEL:
You know, I think we're
gonna see some of it happen.
I don't know how much
of it is going to happen.
The Atlantic provinces
in particular,
these are the places where,
thanks to their own
superior public policy choices,
they have the most healthcare
capacity to spare right now.
Uh, but they're all
relatively small provinces.
Right?
All of the Atlantic provinces
put together
are smaller than the GTA.
Um, so they just
don't really have the staff
to make a huge difference
relative to Ontario's need
right now.
Um, we might
get some from the US.
Obviously the US is sort of
coming out of this, um, phase,
with a much higher
rate of vaccination.
Um, you know,
it will all help,
you know, at the margin,
but I just don't...
I couldn't tell you
how much it's going to matter.
I think the real war,
so to speak, is still gonna be
how effective
public health measures are.
That said, I am willing to
personally express my gratitude
to the east coast
by planning a vacation there
when that's possible
and legal again.
STEVE:
(Laughing)
Good for you.
I'm sure they're
looking forward to meeting you
and hearing you regale them
with stories
of Ontario politics.
Speaking of which, let's
turn our focus to that now.
Since we are the OnPoli Podcast.
And let's look at some of
the politics in all of this.
Now, the Opposition rhetoric,
as a result of
the past weekend's activities
is really starting to heat up.
Liberal leader, Steven Del Duca,
yesterday reiterated
his call for a COVID Czar,
who would take these decisions
about opening up or closing up
out of the political realm.
What do you think about
the advisability of doing that?
JOHN MICHAEL:
You know, as a political
message, I think it's fine.
You know,
it's political communications.
And it's...
You know, it will do what
it is supposed to with voters,
or it won't, and they'll move
onto a different message.
(Laughing)
But, you know me, Steve.
You know that
I'm the kind of person that,
when I heard "COVID Czar",
I immediately was trying
to think about, like,
"How this would this actually
work in the real world?"
And, I don't
understand how it would.
So, you know, let's take
paid sick leave as an example,
because the scientific advisors
have been really consistent
and really clear that they
believe that it's necessary.
Um, what happens when the COVID
Czar says we need paid sick days
and the Ford Cabinet says no?
What happens when the PC
Majority in the Legislature
votes it down
as they have repeatedly?
You know, we have the machinery
of responsible government
in Canada,
and, this feels like a way
of trying to imagine
our way out of it.
But, you can't.
The Tories have
a majority in The Legislature,
and Doug Ford is the Premier.
And, unless one,
or both of those things changes,
you can't try
and plan around them somehow.
STEVE:
Well, this is where
we return to our earlier topic
of whether there is, or isn't,
discontent
on the Tory back bench.
Because Liberal leader
Del Duca also suggested
that Doug Ford has demonstrated
he's incapable of governing,
and has lost the authority
to do so, and should resign.
Those were
the words Del Duca used.
And he even suggested
that there are PC back benchers
who agree with him.
Although he wouldn't say who
they are or how many there are.
Now, when he said that
at yesterday's news conference,
I did suggest to him that
probably the same thing happened
when he was in Cabinet,
when the Liberals were in power,
because government back benchers
do occasionally love to mouth
off to Opposition members
about how bad things are.
You know,
there's nothing new in that
and I wondered whether
this was any different.
And Del Duca said it was.
He said that the illnesses
and deaths being suffered
brought the complaints
to a whole new level.
And I think he said
"This isn't like
disagreeing on whether
to lower the speed limit
on the highways.
It's qualitatively different."
If, in fact, there are unhappy
back benchers in the PC Caucus,
how seriously do you think
we should take those comments?
JOHN MICHAEL:
You're right that
99 times out of a hundred,
disaffected back benchers--
I mean it's a story
we all could write
almost blindfolded
at this point.
You know, if you stick around
in politics long enough,
you will see this.
But it is different this week.
For a very simple,
functional reason.
The government still
hasn't passed its budget bill.
People may remember.
It feels like
a million years ago.
Though, it was just March 24th
that Peter Bethlenfalvy
presented the budget
to the Legislature.
And there's
a piece of legislation
that goes with that budget
and it has moved
its way through the process
to the point
where it is now, back...
It will be back
before the Legislature
for its third and
final reading vote this week.
But that's
must pass legislation.
If nothing else,
it is really the foundation
of the government's
pandemic response
for the next several months.
And, you know, normally,
hey, they've got a majority.
This wouldn't even be
worth talking about.
But,
the Tory back bench is furious
and if they are furious enough,
they could actually hold
their own government hostage.
The Opposition,
because it's a majority
Legislature at the moment,
the Opposition
doesn't have the numbers
to threaten to defeat
the government on this.
But, the Opposition,
plus, maybe 12 Tory MPP's,
would be enough
to credibly threaten
the government's
survival really.
That's, like,
the nuclear option.
And, you know, I should say
that I really don't think
it's going to go that far.
I think, you know,
Canadian politics tends to
revert to the boring mean,
and you should probably
assume that will be the case
in this week.
But, normally I wouldn't
even be talking about this.
It would be inconceivable
that a majority government's
budget wouldn't pass,
but tempers are so high and
nerves are so frayed right now,
that I think it's
absolutely worth talking about.
STEVE:
12 discontented MPP's though
prepared to mutiny against
their own Party and Premier?
That's a pretty tall order
for the Opposition.
I mean, that's never happened.
JOHN MICHAEL:
No.
And...
(Laughing)
It is not
the most likely outcome,
but, if they don't use
the leverage they have now,
they're never
getting it back, right?
I mean, by the next budget,
it will be re-election season.
And, if they just
let this moment pass,
the government is gonna
regain all of the control
over the agenda,
especially since...
We haven't even
talked about this.
But, you know,
on Sunday, The NDP announced,
or alleged rather, that
the government is looking
to shut down The Legislature
at the end of the week.
The government House Leader,
Paul Calandra, says that they,
or at least said on Sunday,
that they are looking to protect
the safety of legislative staff
on Monday.
He then said that the government
has no plans to prorogue.
That might be a technical dodge.
We'll see, but, um, you know,
if the back bench wants
to extract any kind of
change in behaviour, let's say,
from the Premier, or Cabinet,
this moment is really
their last chance to do it.
STEVE:
Yeah, now, one last note.
I got a message
last night from a...
How do I...
I wanna protect
this person's identity.
Um, let's just say
a prominent, high-ranking,
greater Toronto area politician.
I'll put it that way.
Saying there are
strong rumbles out there
that a Cabinet shuffle
is in the offing
that could include Rod Phillips,
the former Finance Minister,
coming back into Cabinet,
and Education Minister,
Stephen Lecce
being shuffled elsewhere.
Now, we get these rumours
of shuffles all the time.
There has not, for the record,
been a Cabinet shuffle since
before the pandemic happened.
And you know that...
You know
a significant percentage
of the members of this Cabinet
have really probably worked
longer and harder hours
than ever before.
So it's not unreasonable that
there'd be a shuffle right now.
Um, and these rumours
seemed better
and more deeply sourced
than most Cabinet
shuffle rumours.
Let me put it that way.
What are you hearing?
JOHN MICHAEL:
Uh, well, I have to say that
I'm, on this particular file,
relying on the work
of yourself and other reporters.
I have not
started beating the bushes
on this particular issue.
But, you know, there is
a lot of speculation in public
I would say,
that, in particular,
Stephen Lecce and the,
let's say, reversal last week
of one day saying
that schools would stay open
and then the very next day,
announcing that schools
were going to stay closed.
Um, you know, that,
that represents, at minimum,
a clear disagreement
between a Premier
and his Cabinet Minister,
or, it's a massive reversal,
or, it's a government
that's not really in control
of the education file.
None of which are particularly
good news for Stephen Lecce.
We had NDP leader,
Andrea Horvath, yesterday
calling for
the Solicitor General,
Sylvia Jones' resignation
based on the similar reversal
on the issue of police powers
and closing playgrounds.
Um, you know, she...
her job could be in jeopardy.
You know,
some of this stuff is....
It's difficult to ascribe
responsibility sometimes,
'cause you never know whether
these Ministers
are free-lancing on their own,
or, whether maybe they're
being blamed for directives
that, in fact, came
from the Premier's office.
But, the privilege
of being the Premier
is that Ministers answer to you,
not the other way around.
STEVE:
Oh, Ministers
are cannon fodder
for the Premier.
There is no question.
That is their job.
Their job is to take all
the incoming and, you know,
at all costs,
save the silverware, right?
Protect the Premier himself.
Okay, let's do
one more thing here, JMM.
And that is, of course,
you and I have both
done a lot of interviews
during this pandemic
with a lot of experts.
But I will tell you that
I'm not sure I've heard
a more explicit, honest,
clear version of where we're at
in terms
of the vaccine roll out,
than in
the following interview
that we're about to present.
Just a note, we recorded this
on Friday April 16th,
before the Ontario
government announced
it was dropping
the eligibility age
for AstraZeneca to 40.
So, with that in mind,
here's epidemiologist
and member of Ontario's
Vaccine Distribution Task Force,
Dr. Isaac Bogoch,
from Toronto's
University Health Network.

STEVE:
Generally speaking,
how well do you think
the vaccine
distribution roll out
is going so far?
ISAAC BOGOCH:
There are certainly challenges.
We have to be
transparent about that.
Some things are going okay,
but there are significant issues
that I think
we need to iron out.
I'm totally happy to dive into
both, uh, silos, if you will.
STEVE:
Sure, let's start right now.
What's not working as well as
you'd like to see it be working?
ISAAC BOGOCH:
Okay, so we're gonna start on--
(Laughing)
We'll start off
with what's not working
before what's working.
So, what's not working--
STEVE:
Hey, I'm in media.
That's where we start.
ISAAC BOGOCH:
I love it.
Okay, I'm all in.
I'll just follow your lead.
But, yeah, I think we need to...
We can work on
a few things simultaneously.
One is the communication front.
I think it's pretty fair to say
that we should have more open
and transparent communications
about, you know,
what's going well,
but also what's not going well,
how things are going,
and some of
the internal workings of,
for example
vaccine distribution,
and vaccine allocation.
I think that would alleviate
a ton of concern
in the general public.
The second thing is that
I would really hope
that we could rapidly expand
the role of primary care.
There's about
eight trillion reasons
why you would want to expand
the role of primary care.
That's family physicians
and nurse practitioners.
That don't get
the "primary care" lingo.
But, certainly,
they are involved,
but their role should
be expanded dramatically.
I mean, we can dive into that
for a second, but basically--
STEVE:
Yeah, just tell me
what that means.
"Expanded dramatically"
means nurse practitioners
ought to be allowed
to give the shots?
Is that what you mean?
ISAAC BOGOCH:
I'm saying nurse practitioners
and family physicians,
across the province
should have a much greater role
in administering the shots,
primarily in their own offices.
We do this
in some parts of the province.
There are plans to expand it
throughout the province,
but, I would have hoped
that we would've had
massively expanded this by now.
People trust
their family physician,
or their nurse practitioner.
They obviously can provide
significant counseling,
especially if there's any
questions about the vaccine.
Or sometimes we use
the term "hesitancy."
Although, that's not
entirely accurate all the time.
There's fewer barriers
going to your local
family physician's office.
The family physicians
can certainly adjudicate
who gets the vaccine
in a data-driven
and equitable manner.
There's just
a lot of good reasons
to mobilize family physicians
across the province
more than we're doing now.
STEVE:
Why would that
not yet have been done?
ISAAC BOGOCH:
Uh...
I can't give you
a good answer unfortunately.
It has been done.
It has been started.
There is certainly
a want for this.
It just hasn't...
It hasn't been expanded.
This might involve
another conversation
with people
who are more knowledgeable
on that area than I am.
And I can only provide
superficial depth
to this part
of the conversation.
But, I do know enough
that I would say that
we should be involving them more
and rapidly
expanding their role.
STEVE:
Okay, let's...
All right, in fairness,
let's look at the other side
of the coin as well.
You're trying to get--
ISAAC BOGOCH:
Oh, I'm not done.
There's still more.
(Laughing)
STEVE:
Oh, there's still more
on the down side?
Okay, we're all ears.
Let's go.
ISAAC BOGOCH:
Yeah, yeah,
so, I think just to recap,
number one, communications,
and greater transparency.
Number two is expanding
the role of primary care.
Number three is navigating
the very convoluted
sign-up system, right?
You have a sign-up system
for the pharmacies.
You have a sign-up system
for hospital based vaccination
programs in some cities.
You have a sign-up system
on the province.
Um, and,
you also have eligibility
that's changing with time.
In addition to that,
you have pop-up centres,
and mobile vaccination programs
in high burden areas.
Like, it would be very helpful
to have some, you know,
one-stop shopping,
one location
where you could go "click"
and have all the information
at your fingertips
in a very easy manner,
and sign up for something
that you're eligible for,
or get on a waiting list
very quickly.
I think
we really have difficulties
with the sign-up system.
And, like, you've seen
cottage industries spring up.
Like, there are groups of people
that will essentially act
as a concierge to help
vulnerable populations,
and individuals who can't
figure out the sign-up system
to help them sign up, which,
you know, is unfortunate,
because this is supposed to be
as accessible as possible.
So, like, those are three areas
I think
we can really improve on.
STEVE:
Now, you're a member
of the Ontario Vaccine
Distribution Task Force
and I presume you have
brought these issues
to the attention
of your colleagues.
What's the reaction?
ISAAC BOGOCH:
I think people are pretty aware
of this and I, you know,
I think when we sort of maybe
pivot to the second part,
of what's going well,
I think some of this
might reflect
that there is attention
being paid to these areas.
And, you know, in fact,
we might start to see
some ironing out
of these issues.
So, for starters, the role of
primary care is being expanded.
I would've obviously wanted
to see it expanded quickly,
and sooner,
and much broader than it is,
but, you know,
this is happening.
I think, you know,
really ensuring
that neighbourhoods
that are disproportionately
impacted by the virus
and also by policies
to curb the virus,
really need to have
more access to vaccine.
That's baked into
the second phase
of the vaccine roll out.
This is being
operationalized now.
You know, in a perfect world,
it would be operationalized
in a much swifter manner,
but there still are
some real constraints.
One of the real
constraints is vaccine.
I mean, so, so, you can allocate
more vaccine to these areas,
but obviously,
there's a lot more
than just putting vaccine...
..more vaccine
into an area, right?
You really have to have
very careful
and meaningful communication,
and very meaningful
community engagement
and do everything we can
to lower barriers
to actually getting
the needle in the arm.
So, you've seen
some programs spring up
for example in high density
residential areas.
There's, you know,
door-to-door vaccination.
And, um, you've seen
vaccine clinics pop up
in temples,
in community centres,
and really providing a hyper
local vaccine distribution model
for people that have barriers,
either mobility barriers,
or language barriers,
or financial barriers,
or technology barriers,
any barrier that prevents them
from getting a vaccine.
So, those programs have started.
Now, of course,
I think in a perfect world,
they'd be rapidly expanded,
but they have started.
So, I think at least
that's starting to go well.
And then lastly,
when you look at a numbers game,
you know, week after week,
we are vaccinating
more and more people.
More days than not,
Ontario is vaccinating
over 100,000 people per day.
Which, again, it's good.
It's not good enough.
We're not there yet.
I think we should
really be aiming
for north of 150,000
people per day, but you know,
certainly
there has been some progress
on the number of people
vaccinated per day.
I just wanna make sure that,
obviously that this is done
in an equitable manner,
and, you know,
people are getting vaccinated,
but also, the right people
are getting vaccinated.
STEVE:
Mm-hm, okay, one more thing
to follow up there
before we look
at the happier side
of the way things are going.
And, that is...
And you just have
to trust me on this
that I'm not trying
to start a food fight
between you and
your political colleagues.
But when you say
that one of the problems
that you're
encountering right now
is ineffective communications,
I infer from that
that the Minister of Health,
The Premier of the day,
maybe the Solicitor General...
I don't know who.
Maybe
the Medical Officer of Health.
Um, they're not speaking
out of the same hymn book,
so to speak, or they're
getting mixed messages,
or what is it?
You tell me.
ISAAC BOGOCH:
Well, I think, when...
Like, first I think
we have to recognize
that this is truly
a public health crisis.
It is.
I don't think you can
see it any other way.
And, if you have a crisis,
be it a public health crisis,
or any other crisis, you need
to have crisis communication.
And crisis communication means
you need to have a daily update,
the same person,
at the same place,
at the same time, every day.
And just talk about
what's going on, what's new,
what's going well,
what's not going well,
and how you're gonna
improve what's not going well.
And, then take questions from
the media or the general public.
And, the beautiful part is,
if you are asked a question
that you don't know
the answer to, guess what,
you're gonna be there
exactly 24 hours later
and you have 24 hours to figure
it out and inform the public.
And, I think
with a communication strategy
like that,
you really have more trust
from the general public,
especially when you need
trust the most, right?
This is, at the end of the day,
this is a massive public health
initiative, to vaccinate,
you know
14 and a half million people,
or who's ever eligible
in Ontario.
And you really need
trust and buy-in.
And part of having
trust and buy-in
is having clear, open,
transparent communications,
and just being honest about,
you know, what's going well,
but also being totally honest
about what's not going well
and how
you're going to improve that.
STEVE:
All right, one of the things
that we have heard,
and I noticed this was
not on your list of criticisms,
so maybe it's not a problem.
Maybe it just needs explaining,
so I wanna put this to you.
We have heard
from critics who say
"Why are there
hundreds of thousands of doses
sitting in freezers
while appointments
are being cancelled?"
First of all,
is that in fact the case?
And second of all,
if it is, is it a problem?
ISAAC BOGOCH:
So, this is like those
old Facebook updates
from the early 2000's, right?
It's complicated.
(Laughing)
Right?
The nuance is important.
And, I think it's fair to say
that, you know,
there certainly
are vaccines in freezers.
But, let's dig
a little deeper here.
We have three different vaccines
in the province at the moment.
One is Pfizer.
One is Moderna.
And one is AstraZeneca.
We get our Pfizer shipments
once a week.
We get roughly 400,000 doses
of Pfizer once a week.
When Pfizer comes in...
And it comes in like clockwork.
It comes in regularly.
We don't have any delayed
shipments of Pfizer these days.
When it comes in,
it takes about a day or so
to get distributed
throughout the province
and then it gets administered
in mass vaccine clinics.
By the end of the week,
there's very little Pfizer left.
There's some.
You always have
a little bit for wiggle room.
Usually I keep a day or so
just in case, but by and large,
the burn rate
through Pfizer is quick.
Moderna is the other mRNA
vaccine that we get access to.
And we get hundreds
of thousands of doses of that
delivered every other week.
One of the issues with Moderna
is that for, you know,
several different reasons
that are well above my pay grade
is that
there are delays in shipment.
There are.
And, it's challenging because
the burn rate through Moderna
is also pretty quick.
Like, at the end of two weeks,
you don't have a ton
of Moderna left in the freezer.
You just don't.
It gets used up.
But, you have
a little bit of wiggle room
in case there are
supply chain issues or delays.
And then you can
use that Moderna up
so that you don't have
to cancel appointments.
But there are delays
in Moderna unfortunately
and that certainly has impacted
some part of the roll out.
Sadly, there's also,
recently announced,
and announced in the past,
sometimes when you get
a shipment of Moderna,
you don't as much
as you wanted.
And, in fact,
that's happening right now.
So, that's also problematic.
Um, the third vaccine
is AstraZeneca.
We don't...
We have a big contract
for AstraZeneca,
but we don't actually
get AstraZeneca
with any regular frequency.
We've had a couple of
boluses of AstraZeneca.
And AstraZeneca is
administered by primary care.
So that means
nurse practitioners
and family physicians
in a few parts of the province.
It's also administered
in soon to be,
or up to 1,400 pharmacies
scattered throughout
the province.
There was a few hundred
that went online
and then a few hundred that are
either actively coming online,
or now online.
It should be about 1,400 by now
and about 1,500
by the end of the month.
So, AstraZeneca is administered
by primary care and pharmacies.
It's available to everyone
who's 55 years of age and older.
But, the burn rate,
how much AstraZeneca we consume,
of the hundreds and hundreds
and hundreds of thousands
of doses of that is actually
much, much, much slower
compared to the Pfizer
and the Moderna.
And, you know, we could
explore the reasons as to why
the burn rate through
AstraZeneca is much slower,
but it is much slower.
So, you know,
going back to the question,
when you talk about
vaccines in freezers.
So, you know, when you get
a big shipment of, for example,
Pfizer,
at the beginning of the week,
there's 400,000
doses right there.
Let me take a snap shot.
You know, you'll have maybe
a little bit of residual Pfizer,
a little bit
of residual Moderna,
and you have, you know,
a bunch of AstraZeneca as well.
When you take
a snap shot in time,
yeah, you've got
1.1 million doses of vaccine
that are sitting there unused.
But of course,
if you follow that stockpile
throughout the week,
and you follow your Pfizer
throughout the week,
and your Moderna
throughout the week,
and of course the next week,
'cause Moderna's administered
every two weeks, those go.
Those go pretty quick.
They're all allocated.
They all go pretty quick.
And it really is
largely the AstraZeneca
that's sticking around.
I know that's a long-winded
answer, but that's the answer.
So the question, "How do you--"
STEVE:
No, no, that--
ISAAC BOGOCH:
Oh, sorry.
Go ahead.
STEVE:
I was just gonna say
that actually makes sense
and that clarifies it.
And I guess
we should finish up on this,
which is where you left off,
and that's AstraZeneca.
And I do wonder,
and in the interest of
full disclosure, I'm over 55.
I got my first AstraZeneca shot.
Um, you know...
How do I put this?
I interviewed somebody
on
The Agenda
who said,
"You got two
different risks to weigh here.
You can run the risk
of getting COVID-19,
because you're nervous
about getting the AZ shot,
or you can deal with the risk
of potential blood clots
with the AZ shot."
So I got the shot and I said,
"That's a risk
I'm happier to take
as opposed to the risk
of getting COVID-19
and dying altogether."
How much reputational damage
do you think AstraZeneca
has suffered because
of the whole blood clot issue?
ISAAC BOGOCH:
Tremendous.
I think it's had
tremendous reputational damage.
And it goes well beyond
the blood clot issue.
It starts with
their first clinical trial,
when they really
had messed up the dosing
and had
some places get one dose,
and other places
get a second dose,
and they mushed
all the studies together
and pretended that it was
a robust, clinical trial.
But it was
pretty sloppy science.
And that was their first mishap.
Then we've, you know,
in Canada, again, people...
I'm leaving out value judgments
here, but, we've said in Canada,
"We're not gonna give this
to people over the age of 65."
Then, "We are gonna give it
to people over the age of 65."
Then, "We're not gonna give it
to people under the age of 55."
That...
Those policy changes, you know,
you can defend
or criticize them,
but I think it's fair to say
that we have to communicate
any changes
in a very effective manner
so that we don't further
erode trust in the vaccine.
And, I think many would argue
that perhaps the communication
of those policy changes
was not ideal.
The third is the company
came out
with another clinical trial.
Really well done.
Really well done.
Over 30,000 people enrolled.
It wasn't sloppy like
their first clinical trial.
And they published some interim
results through a press release.
And that'd look great.
79 percent efficacy.
But, their independent
data safety monitoring board
called them out
publically and said,
"You're not
using the right data.
That data isn't up to date.
You have to use the right data."
And this was, I don't know
if people remember this.
This was only a few weeks ago.
But, like the company said, "Oh,
no, no, this is the right data.
We'll come up with
our new data in 48 hours."
They came up with
their new data
which was updated,
that demonstrated something,
like, almost identical,
74 percent efficacy.
But, this was
completely preventable.
Like, you're in
the international media
getting called out by your
data safety monitoring board
for nothing.
For absolutely...
For a 79 versus
a 74 percent efficacy headline.
Like, it was ridiculous.
And again,
it all erodes public trust.
And then of course
comes the blood clots.
You can't ignore 'em.
They're rare.
It's not fair to say that we
know what the true incidence is,
but it's pretty fair to say
that we know that they're rare.
It has to be contextualized.
We can contextualize risk.
You know, we know that COVID-19
is a pretty dangerous infection.
We know that
the variants of concern
are really harming people,
even younger people.
We know that these vaccines
are really, really effective
in reducing the risk
of getting any infection,
and if people are infected,
reducing the risk of
landing in hospital or dying.
We have to contextualize risk
in a much better way.
You can't
ignore the blood clots.
You can't.
But you have to discuss them,
and contextualize them,
and enable people to make
good decisions for themselves.
And of course, many will
decide not to get the vaccine,
but I think many more would
decide to get the vaccine
if we communicated risk
and contextualized it
in an effective manner.
And I don't think we have.
STEVE:
Well, which you have just done.
So, is the advice still,
from you, as we sit here
talking about this,
the risk of taking
AstraZeneca is less significant
than the risk of getting
COVID-19, so take the jab?
Is that still your position?
ISAAC BOGOCH:
Yes.
Essentially that is.
But here's, I would say--
But wait!
There's more.
I would say that
given the current context
that we're in right now.
So, you know, obviously
we always have to time stamp
our conversations.
It's April 16th
as we're talking right now.
We have record high numbers
of COVID-19 in the country.
We have record high numbers
of COVID-19 in Ontario.
Ontario's healthcare system
is not about to be
stretched beyond capacity.
It is stretched beyond capacity.
As in,
we are cancelling operations
to care for
and to get all hands on deck.
We are calling in the troops,
re-deploying staff,
admitting adults into
pediatric intensive care units.
Like, it's pretty fair to say
we're about
to put people into tents
outside of several major
hospitals in Toronto.
It's fair to say that we have
stretched beyond capacity.
And you have a vaccine
that can truly save lives.
Why not just give it
to everyone age 18 years and up,
as per Health Canada,
with informed consent?
You know,
inform people, and say,
"Listen, you can choose
to get this if you want.
Here is the risk that
we know of for adverse events.
And, you know,
in the current context of truly,
you know, widespread
community transmission
and hospital systems
stretched beyond capacity,
you know,
you can decide whether
this is something that you're
interested in taking or not.
I bet we would not.
We would...
Just, our stockpile
would evaporate over night.
STEVE:
Hm, well that is clear
and concise communications.
So we appreciate having
you on for that very reason.
Thanks for the time.
ISAAC BOGOCH:
My pleasure.
Have a great day.
STEVE:
You too.

JOHN MICHAEL:
That was Dr. Isaac Bogoch,
epidemiologist,
and member of Ontario's
Vaccine Distribution Task Force.
And, um, I will simply say
that if the government
had that level of clarity
and communications,
I think they would be suffering
a lot fewer problems right now.
STEVE:
Amen to that.
This guy can communicate.
He sure can.
All right, folks,
we always conclude this podcast
with our favourite
quotes of the week.
And we'll have that for you
immediately after we ask you
as we always do, to give us
a rating on Apple Podcasts.
We do like to know
what you liked, what you didn't.
And try
to help make this podcast
just a little bit better.
JOHN MICHAEL:
Here's a note we got
from Michael Healey
on Twitter who wrote,
"Shout out to the OnPoli Podcast
with jm_mcgrath and spaikin,
a great, spin-free resource
for all things
Ontario politics."
STEVE:
Hey, thank you, Michael.
That is very encouraging.
Here now, my quote of the week,
and it's from Liberal leader,
Steven Del Duca, who held
two news conferences yesterday.
The second of which called on
Doug Ford to resign as Premier.
Here's our exchange
starting with my question.
My question is:
It is impossible
for me to believe
that the Premier of Ontario
is going to take advice
on whether
to stay in office or resign
from the leader of a party
that is not
officially constituted,
and the leader
doesn't have a seat.
So, what is the value
in making the announcement
that you just did?
STEVEN DEL DUCA:
Well, 'cause leaders
have to lead, Steve.
And Doug's not doing it.
Doug's not a leader.
And we're all
suffering as a result of it.
Every single person
in this province is.
And this is a life
and death circumstance.
This is not the same as
any other political decision
or political issue
that might come up.
This is life and death
in this province right now.
And there are examples
in western democracies
of leaders
in life and death situations,
who've recognized
they don't have what it takes
to get the job done.
STEVE:
That's Steven Del Duca,
leader of the Ontario Liberals,
who went on to say, Neville
Chamberlain stepped aside
for Winston Churchill,
so there is precedent
for a leader stepping aside
if, in the judgement
of the party,
there's a better option
elsewhere in Caucus.
JOHN MICHAEL:
My quote of the week comes
from the modelling briefing
that we were discussing
at the top of the podcast.
This is a quote
from Dr. Adalsteinn Brown,
of the University of Toronto,
who asked the public...
And I know
that it's been a long year.
And it can be easy to lose track
of what
we have all gone through.
And this is Dr. Brown
reminding us all to notice
what is going on
and to act accordingly.
ADALSTEINN BROWN:
Cases have risen.
Hospitals have filled up.
And across Ontario,
it is very clear
we are very much
in the third wave of COVID-19.
And the numbers
are still rising.
But the biggest problem
we now face
may be that we're just
too tired to notice.
So I'm begging you
as part of the team to notice.
Notice that our hospitals
can no longer function normally.
They are bursting
at their seams.
We're setting up
field hospitals.
And we are separating critically
ill patients from their families
by helicoptering them
across the province for care.
JOHN MICHAEL:
That was Dr. Adalsteinn,
"Steini," Brown,
speaking at
Queen's Park on Friday.
STEVE:
And, that was episode 108
of the OnPoli Podcast.
Produced by Katie O'Connor,
editing by Matthew O'Mara,
production support
from Nikki Ashworth
and Jonathan Halliwell.
JMM, as my dad likes to say,
and these words seem
particularly important
these days:
"Stay positive.
Test negative."
JOHN MICHAEL:
Stay safe, Steve.

Watch: Ep. 108 - Are vaccines languishing in freezers?