Transcript: Tracking Ontario's Progress Against Covid-19 | Mar 19, 2021

Nam sits in the studio. She's in her early forties, with shoulder length straight brown hair. She's wearing glasses and a dark green blazer over a black shirt.

A caption on screen reads "Tracking Ontario's progress against COVID-19. Nam Kiwanuka, @namshine, @theagenda."

Nam says FIRST, THE GOOD NEWS: ONTARIO'S BOOKING SYSTEM FOR VACCINATIONS CAME ONLINE THIS WEEK. BUT, THE BAD NEWS: DUE TO GROWTH IN THE VARIANTS OF CONCERN, ONTARIO'S CHIEF MEDICAL OFFICER, DAVID WILLIAMS, HAS DECLARED THAT THE PROVINCE IS OFFICIALLY IN A "THIRD WAVE." WITH US TO BETTER UNDERSTAND WHERE WE'RE AT AND WHERE WE'RE HEADED, IN THE NATION'S CAPITAL, RAYWAT DEONANDAN, EPIDEMIOLOGIST AND ASSOCIATE PROFESSOR AT THE UNIVERSITY OF OTTAWA'S FACULTY OF HEALTH SCIENCES...

Raywat is in his forties, clean-shaven, with short black hair in a pompadour. He's wearing a white shirt, black tie and gray vest.

Nam continues AND HERE IN THE PROVINCIAL CAPITAL, ASHLEIGH TUITE, INFECTIOUS DISEASE EPIDEMIOLOGIST AT THE UNIVERSITY OF TORONTO'S DALLA LANA SCHOOL OF PUBLIC HEALTH.

Ashleigh is in her forties, with long curly brown hair. She's wearing a blue shirt.

Nam continues WELCOME BACK TO YOU BOTH. MY VOICE IS A LITTLE OFF. I LOST IT YELLING AT MY CHILDREN COMMUNICATING NOT YELLING. THANK YOU WE HAVE A LOT TO GET INTO THIS THE NEXT 25 OR SO MINUTES. RAYWAT, ON THURSDAY DAVID WILLIAMS ANNOUNCED THE PROVINCE IS OFFICIALLY IN A THIRD WAVE. WHAT DOES THAT MEAN?

The caption changes to "Raywat Deonandan. University of Ottawa."

Raywat says IT MEANS WE'RE IN THE THIRD HOPEFULLY FINAL SURGE OF THIS PANDEMIC. THE NUMBERS ARE RISING. THEY'RE MOUNTING FAST AND IT LOOKS LIKE OUR ICUS WILL BE QUITE STRESSED VERY SOON. THIS TIME AROUND I DON'T KNOW IF THE MORTALITY RATE WILL BE AS HIGH BECAUSE WE HAVE VACCINATED MOST OF OUR LONG-TERM CARE AND TERMINAL RESIDENTS BUT THE FOCUS OF THE DISEASE IS SHIFTING TO THE YOUNGER DEMOGRAPHIC, THOSE BETWEEN 40 AND 79 AND THE NEW VARIANTS APPEAR TO BE AS LETHAL IN THAT GROUP. SO I ANTICIPATE SOME SUFFERING. THIS IS NOW A HEALTH SYSTEMS CRISIS AS IT WAS A YEAR AGO. LESS OF A MORTAL CRISIS, BUT A CRISIS NONETHELESS.

Nam says I KNOW PEOPLE ARE TIRED. THERE'S A LOT OF FRUSTRATION, A LOT OF FAMILIES HAVE LOST LOVED ONES AND THERE'S BEEN A LOT OF PAIN THIS PAST YEAR. DR. WILLIAMS SAID IT IS THE THIRD WAVE BUT HE SAID: "IT IS JUST A MATTER OF WHAT KIND OF WAVE IT IS." IF WE'RE IN THE THIRD WAVE, WHY IS THE TYPE OF WAVE IMPORTANT TO IDENTIFY, RAYWAT?

Raywat says TYPE OF WAVE. WELL, I THINK WHAT HE MEANS BY THAT IS IT'S GOING TO BE ONE WITH EXTRAORDINARY DEATH TOLL. IT'S GOING TO BE ONE WITH EXTRAORDINARY ICU USAGE OR ONE WITH JUST CASES MOUNTING. WE HOPE IT'S THE LAST ONE. BUT IT'S LIKELY TO BE ONE WITH EXTRAORDINARY ICU USAGE AND CONSIDERABLE DEATH AS WELL. BUT DEPENDING HOW QUICKLY YOU RESPOND AND HOW MUCH WE VACCINATE AHEAD OF THIS, WE MAY BE ABLE TO SHORTEN THE WAVE TO SOMETHING NOT LIKE THE LAST ONE. MAYBE A FEW WEEKS RATHER THAN MONTHS. WE'LL SEE WHAT HAPPENS.

Nam says ASHLEY, LEADING UP TO THE ANNOUNCEMENT WE'VE HEARD THERE IS A POSSIBILITY OF A THIRD WAVE BECAUSE OF VARIANTS OF CONCERN. WHAT ARE THESE VARIANTS AND WHY ARE THEY CALLED VARIANTS OF CONCERN?

The caption changes to "Ashleigh Tuite. University of Toronto. Dalla Lana School of Public Health."
The caption changes to "The variants of major concern."

Ashleigh says THEY'RE CALLED VARIANTS OF CONCERN BECAUSE THEY'RE BASICALLY CHANGES FROM THE ORIGINAL VARIANT THAT IS WERE CIRCULATING AND THEY'RE CONCERNING. THE NAME SORT OF TELLS US WHAT IT IS. THE REASON THAT THEY'RE CONCERNING IS BECAUSE THE VIRUS HAS CHANGED OVER TIME SINCE IT'S BEEN WITH US FOR OVER A YEAR NOW. IT'S ACQUIRED MUTATIONS OR CHANGES TO ITS GENETIC MATERIAL. AND SOME OF THOSE CHANGES HAVE MADE IT MORE TRANSMISSIBLE. SO THAT MEANS IF A PERSON IS INFECTED THEY CAN SPREAD IT MORE EASILY TO OTHER PEOPLE AND SOME OF THESE CHANGES HAVE MADE THE VARIANTS RESISTANT TO VACCINE SO THEY DON'T RESPOND AS WELL OR YOU DON'T MOUNT AS STRONG AN IMMUNE RESPONSE AND SOME ARE LETHAL. IF YOU DO GET INFECTED YOU ARE MORE LIKELY TO DIE. IT IS SORT OF PART OF THE NATURAL EVOLUTION OF ANY SORT OF PATHOGEN. BUT IT MAKES OUR RESPONSE OVER THE NEXT COUPLE OF MONTHS REALLY IMPORTANT BECAUSE WE'RE DEALING WITH THESE CHANGED VARIANTS OF THE VIRUS. AND OUR CONTROL BECOMES MORE CHALLENGING.

Nam says WOULD IT BE SAFE, THEN US TO SAY THAT THIS IS A DIFFERENT PANDEMIC OR JUST AN EXTENSION OF THE SAME PANDEMIC?

The caption changes to "Ashleigh Tuite, @AshTuite."
Then, it changes again to "Watch us anytime: tvo.org, Twitter: @theagenda, Facebook Live, YouTube."

Ashleigh says THE WAY THAT I THINK ABOUT THIS IS THERE ARE REALLY TWO PANDEMICS HAPPENING RIGHT NOW. WE HAVE THE PANDEMIC WHICH IS OF THE ORIGINAL VARIANT AND UNDERNEATH WE HAD THIS NEW PANDEMIC WHICH ARE THESE NEW VARIANTS OF CONCERN THAT ARE MORE TRANSMISSIBLE, SOME OF WHICH CAUSE MORE SEVERE ILLNESS THAT WAS HAPPENING, YOU KNOW, SINCE WE FIRST RECOGNIZED IT IN ONTARIO AT THE END OF DECEMBER WE STARTED FIRST SEEING CASES AND IT'S BEEN SORT OF HAPPENING WITHOUT US SEEING IT. WE KNEW THAT THE CASES WERE HERE. WE KNEW THAT THEY WERE STARTING TO SPREAD. BUT OVERALL IN THE PROVINCE WE WERE SEEING DECLINING CASES. BUT UNDERNEATH THAT, THE CASES OF VARIANTS WERE INCREASING. AND WHAT WE'RE SEEING RIGHT NOW IN TERMS OF THIS INCREASE IN CASES IS THE VARIANTS HAVE ESTABLISHED A FOOTHOLD. THEY'RE TRANSMITTING MORE READILY IN OUR POPULATION AND THAT PUTS CONTRIBUTING TO THE RESURGENCE IN CASES.

Nam says YOU SAID WE DIDN'T SEE THIS. HOW DID WE NOT SEE THIS COMING?

Ashleigh says TO BE HONEST WE SAW THIS COMING. I MEAN WE KNEW THAT THE VARIANTS WERE HERE. WE HAD SURVEILLANCE IN PLACE. THANKS TO OTHER COUNTRIES THAT HAVE HAD REALLY GOOD GENOMIC SURVEILLANCE WE WERE LOOKING FOR THESE VARIANTS WHEN I SAID WE DIDN'T SEE THIS WHAT I MEANT IS IF YOU LOOK AT THE PANDEMIC CURVE I THINK WE HAD A FALSE SENSE OF SECURITY IN JANUARY WHEN WE SAW CASES DECLINING. IT WAS A LITTLE HARD TO SEE VARIANTS ESTABLISHING THEIR FOOTHOLD BECAUSE WITH EXPONENTIAL GROWTH YOU START WITH SMALL NUMBERS OF CASES AND THOSE CAN GROW REALLY RAPIDLY. SO IT TAKES A BIT OF TIME FOR THAT TO BECOME ESTABLISHED. BUT ONCE IT BECOMES ESTABLISHED, THE SITUATION CAN CHANGE REALLY RAPIDLY.

Nam says ONE OF WAYS THE GOVERNMENT HAS BEEN COMMUNICATING THE NUMBERS IN THE PROVINCE ARE THE DAILY... WHEN THEY RELEASE THE NUMBERS ON THE DAILY BASIS BUT, RAYWAT THOSE NUMBERS DON'T REALLY REFLECT WHAT'S HAPPENING RIGHT NOW. HOW COME?

The caption changes to "Raywat Deonandan, @deonandan."

Raywat says THERE'S A LAG IN REPORTING, TESTING AND GENOMIC SURVEILLANCE. BY WHICH I MEAN DETERMINING WHAT PROPORTION OF OUR CASES ARE, IN FACT, THE VARIANTS THAT TAKES TIME. SO THERE'S A FULL GENOMIC DISENTANGLING OF THE VIRUS TO ANALYSE WHICH ONES ARE, IN FACT, A VIRUS. WE HAVE A HAND WAVING METHOD USING WHAT'S CALLED THE PRR TEST TARGET, DIFFERENT PORTIONS OF THE GENES AND THE "S" GENE IS THE ONE THAT THE NEW MUTATIONS HAVE A PROBLEM WITH ADD TO THE PCR. LONG STORY SHORT: THERE ARE DIFFERENT WAYS OF DISCOVERING WHETHER OR NOT THERE IS A VARIANT PRESENT. I'M NOT A LAB GUY. I DON'T FULLY UNDERSTAND IT. BUT MY UNDERSTANDING IS IT TAKES TIME. AS A RESULT, ANY DATA YOU SEE NOW IS PROBABLY TOO OLD.

Nam says IS THERE A POINT IN DOING THAT, ASHLEIGH?

Ashleigh says YEAH, THERE ARE A NUMBER OF REASONS WE WANT TO DO THAT. WE HAVE THESE PARALLEL EPIDEMICS HAPPENING EVEN IF THE DATA ARE DELAYED WE NEED TO UNDERSTAND WHAT'S HAPPENING. AS RAYWAT WAS DESCRIBING THERE IS A FASTEST WE CAN DO AND THEN THERE'S A SLOWER TEST. THAT INITIAL TEST WE CAN DO TO SCREEN FOR THESE VARIANTS OF CONCERN IS DELAYED BUT IT'S A COUPLE OF DAYS. THAT INFORMATION COMES TO US IN A MORE TIMELY MANNER AND IT TAKES A BIT LONGER TO DO THE FULL GENOMIC WORK OUT. BUT THE REASON THAT WE WANT TO LOOK FOR THIS IS BECAUSE FIRST OF ALL WE NEED TO UNDERSTAND WHAT WE'RE DEALING WITH. AND SECOND OF ALL, THE GENOMIC EPIDEMIOLOGY IS REALLY IMPORTANT. BECAUSE THE VARIANTS THAT WE SEE RIGHT NOW ARE NOT THE ONLY VARIANTS THAT WE'RE GOING TO HAVE TO DEAL WITH. WE NEED TO BE ABLE TO IDENTIFY NEW ONES THAT WILL MERGE. THE ONLY WAY TO DO THAT IS BY GENOMIC SURVEILLANCE.

Nam says BEFORE WE STARTED TAPING AND RAYWAT I HOPE I'M NOT PUTTING YOU ON BLAST. BUT YOU SAID THIS PANDEMIC WOULD LAST FOUR YEARS. IN THE SPAN OF A YEAR WE HAVE VACCINES AND WE HAVE MULTIPLE VACCINES NOW FOR PEOPLE TO CHOOSE FROM IN THE WINDOW OF A YEAR. YET, THERE HAS BEEN CONTROVERSY ABOUT ONE VACCINE, THE ASTRAZENECA. HOW COME?

The caption changes to "The race to vaccinate."

Raywat says A COUPLE OF THINGS. ONE IS THE REPORT OF BLOOD CLOTS IN SOME EUROPEAN POPULATIONS AND THE OTHER IS WHETHER OR NOT THIS VACCINE IS RELEVANT FOR THOSE OVER 65. LET'S DEAL WITH BLOOD CLOTTING FIRST. APPARENTLY WE HAVE ABOUT 30 CASES OF SEVERE BLOOD CLOTS SOME LEADING TO DEATH IN A POPULATION OF ABOUT 5 MILLION OR 15 MILLION DEPENDING WHICH DENOMINATOR YOU WANT TO USE. THAT WORKS OUT TO AN INCIDENCE RATE OF 0.600 percent. IS THAT A LOT? THE JENKINS DENSE IS ABOUT 0.2 percent. AND IF YOU ARE ON CONTRACEPTIVE MEDICATION, A WOMAN WHO IS CHILD BEARING YEARS THE RISK IS 0.29 percent. IF YOU ARE A HOSPITALIZED PERSON OR TAKING A FLIGHTED WITHIN 48 HOURS OF THE FLIGHT YOUR RISK IS 2 TO 10 percent. SO EVEN IF THERE IS A CAUSAL RELATIONSHIP BETWEEN THE BLOOD CLOT AND THE VACCINE AND THAT'S NOT BEEN SHOWN YET, IT MIGHT JUST BE COINCIDENTAL, IT SEEMS IT IS FAR MORE LIKELY TO EXPERIENCE BLOOD CLOTS IF YOU AREN'T ON THE VACCINE. I THINK THAT'S REALLY OVERBLOWN THE RISK. THE OTHER ISSUE IS, IS THIS VACCINE RELEVANT FOR THOSE OVER 65. NOW, THE CLINICAL TRIALS THAT ASTRAZENECA FIRST SUBMITTED DIDN'T ENROLL A SUFFICIENT NUMBER OF OLDER PEOPLE FOR SOME STATISTICIANS TO FEEL CONFIDENT IN CONCLUDING AN EFFICACY SCORE. THAT'S DIFFERENT THAN DETERMINING IT DOESN'T WORK. SINCE THEN, THE WE HAVE A REAL-LIFE DATA COMING OUT OF PLACES LIKE ENGLAND AND SCOTLAND SHOWING THAT, YEAH, IT IS QUITE EFFICACIOUS AMONGST THOSE WHO ARE OLDER. THEREFORE, THE REAL LIFE DATA IS ALWAYS BOTHER THAN THE CLINICAL TRIAL DATA, IN MY OPINION, SO IT IS RIGHT FOR US TO USE THAT VACCINE IN AN OLDER POPULATION. I THINK THESE CONTROVERSIES ARE UNDERSTANDABLE GIVEN THAT THIS IS THE MOST SCRUTINIZED CAMPAIGN IN HUMAN HISTORY AND THAT ANY SMALL BUMP WILL BE AMPLIFIED BY MEDIA. RIGHTLY SO THAT'S THE MEDIA'S JOB. BUT WE HAVE TO KEEP THINGS IN PROPORTION. OVERALL, WHATEVER RISK EXISTS IS MINUSCULE COMPARED TO THE POTENTIAL BENEFIT OF GETTING VACCINATED WITH WHATEVER VACCINE THAT HEALTH CANADA HAS OKAY'D BECAUSE THEY'RE ALL SAFE AND EFFICACIOUS.

Nam says I'M GLAD YOU POINTED THAT OUT. I THINK A LOT OF PEOPLE'S NERVES ARE FRAYED AFTER THIS PAST YEAR. ASHLEIGH, WHEN YOU LOOK AROUND THE WORLD WHERE IS THERE AN APPROVAL PROCESS FOR ASTRAZENECA GLOBALLY.

Ashleigh says THE ASTRAZENECA VACCINE IS APPROVED IN VARIOUS COUNTRIES AROUND THE WORLD. I THINK IT'S A PRETTY FLUID SITUATION. I MEAN THE ONE PLACE WHERE IT HASN'T BEEN APPROVED YET IS THE UNITED STATES. AND THAT'S BECAUSE THEY HAVE DIFFERENT REQUIREMENTS IN TERMS OF THE TRIAL DATA THAT THEY'RE REQUIRING. AND I THINK, YOU KNOW, IT'S REALLY IMPORTANT. RAYWAT WAS DESCRIBING THE RISKS THAT... THESE SIGNALS THAT HAVE BEEN COMING UP IN TERMS OF IF THEY GIVE THE VACCINE. I THINK IT'S REALLY IMPORTANT, FIRST OF ALL, FOR EVERYONE TO RECOGNIZE THAT, YOU KNOW, THAT IS PART OF THE PROCESS OF USING NEW VACCINES IN POPULATIONS. WE NEED THAT SURVEILLANCE. WE NEED PEOPLE TO BE LOOKING FOR THOSE SIGNALS BECAUSE WE NEED TO INVESTIGATE THEM. WE NEED TO UNDERSTAND WHAT'S GOING ON. AND, YOU KNOW, THERE ARE GOING TO BE SET BACKS. YOU KNOW, IT'S POSSIBLE THAT WE WILL SEE RECOMMENDATIONS CHANGE. WE MAY SEE THINGS THAT ARE NO LONGER RECOMMENDED FOR CERTAIN POPULATION GROUPS BUT THAT'S REALLY PART OF WHAT HAPPENS AS WE MOVE FROM THE TRIAL WHICH IS DONE IN A PRETTY SMALL POPULATION GROUP TO, YOU KNOW, STARTING TO VACCINATE MILLIONS OF PEOPLE IS WE'RE GOING TO START PICKING UP THESE SIGNALS, PIVOT OR CHANGE. AND, AGAIN, THAT'S PART OF THE SCIENCE WORKING. AND I THINK IT'S REASSURING THAT WE'RE FINDING THESE SIGNALS AND INVESTIGATING THEM AND RESPONDING.

Nam says THE ASTRAZENECA VACCINE IS THAT THE ONE THAT THEIST IS GIVING CANADA.

Ashleigh says YES.

Nam says BUT THEY HAVEN'T APPROVED IT FOR AMERICANS.

Ashleigh says NO. I THINK THAT'S PART OF THE REASON THAT THEY'RE GIVING IT IS THEY HAVE THIS VACCINE IN WAREHOUSES BUT IT HASN'T BEEN APPROVED YET.

The caption changes to "Subscribe to The Agenda Podcast: tvo.org/theagenda."

Nam says HOW DO YOU GET CANADIANS THEN... NOT TO INTERRUPT YOU... IF CANADIANS HEAR THAT, THEN HOW DO YOU GET THEM TO UNDERSTAND THAT HAVING THE VACCINE IS BETTER THAN NOT HAVING IT?

Ashleigh says I MEAN IT'S COMPLICATED. YOU KNOW, EVERY COUNTRY HAS APPROVED DIFFERENT VACCINES AND EVERY COUNTRY HAS DIFFERENT PROCESSES FOR APPROVING VACCINES. I THINK AT THIS POINT THE RISKS ASSOCIATED WITH THE VACCINE ARE SO MUCH LOWER THAN THE RISKS ASSOCIATED WITH GETTING COVID. AND, AGAIN, YOU KNOW, I THINK PEOPLE NEED TO BE REASSURED THAT, YOU KNOW, WHENEVER THERE ARE WORRYING SIGNALS, PEOPLE ARE INVESTIGATING THIS. AND WE'VE SEEN IN THIS IN EUROPE THEY STOPPED ADMINISTERING ASTRAZENECA AS SOON AS THEY HAD THE SIGNAL. THEY REVIEWED THE EVIDENCE AND DECIDED TO PROCEED. MAKING SURE THAT PEOPLE UNDERSTAND WHAT THE RISKS ARE. THEY KNOW IN GERMANY THEY NOW INCLUDE INFORMATION FOR PEOPLE WHO ARE GETTING VACCINATED THAT THERE HAS BEEN THIS ASSOCIATION THAT THEY'RE INVESTIGATING WITH CLOTS. AND SO THAT YOU CAN MAKE AN INFORMED DECISION.

Nam says AS THE ONTARIO ROLL OUT BEGINS TO HAPPEN, RAYWAT, ONE OF THE SUGGESTIONS THAT'S BEEN MADE THAT MAYBE WOULD BE BENEFICIAL TO PEOPLE IN THE HOT ZONES IS THAT TARGET THE HOT ZONES FIRST. DOES THAT MAKE SENSE?

Raywat says BEFORE I ANSWER THAT QUESTION, I THINK IT'S IMPORTANT TO POINT OUT THAT THE MESSAGING AROUND VACCINES NEEDS TO BE SIMPLIFIED. IT HAS TO BE SOMETHING VERY BASIC LIKE ALL THE VACCINES THAT WE'VE OKAY'D KEEP YOU OUT OF HOSPITAL AND THEY KEEP YOU OUT OF THE MORGUE. AND THE GOAL IS TO GET IMMUNITY AS FAST AS POSSIBLE TO KEEP PEOPLE OUT OF THE HOSPITAL. I THINK THAT SIMPLE MESSAGE HAS BEEN LOST. WE TALK ABOUT RISKS, EFFICACIOUSNESS, ALL THESE OTHER ISSUES SO PEOPLE ARE WAITING FOR THE BETTER DOSE MOSQUITOES DOWN THE LINE RATHER THAN TAKING WHAT'S ON OFFER NOW. THEY ALL KEEP YOU OUT OF THE HOSPITAL. THEY ALL KEEP YOU OUT OF THE MORGUE. THAT'S ALL WE SHOULD CARE ABOUT. TO ANSWER YOUR QUESTION, DOES IT MAKE SENSE TO FOCUS ON THE HOT ZONES? THERE ARE DIFFERENT WAYS OF THINKING ABOUT VACCINE DEPLOYMENT. THERE IS THE THE EPIDEMIOLOGICAL PERSPECTIVE, WHAT KEEPS PEOPLE OUT OF THE HOSPITAL MORE, WHAT KEEPING THE ACADEMIC CURVE LESS, WHAT GETS US FASTER TO HERD IMMUNITY. THERE IS ALSO THE EQUITY ISSUE WHERE PEOPLE FEEL THIS IS A FAIR WAY TO DISTRIBUTE. DISENTANGLING THOSE FACTORS IS IMPORTANT. I THINK IT DOES MAKE SENSE TO POUR WATER WHERE THE FIRE IS BRIGHTEST AND HARSHEST. TO USE THE METAPHOR. THAT'S THE WAY WE GET THE EMERGENCY UNDER CONTROL FASTEST. THAT'S ONLY POSSIBLE IF PEOPLE GO ALONG WITH IT. I'M FOND OF SAYING THAT PUBLIC HEALTH IS THE ART OF THE POSSIBLE AND WHAT IS POSSIBLE IS GAUGED BY WHAT PEOPLE WILL TOLERATE. IF YOU ARE IN A NON-HOT ZONE AREA WONDERING WHY DOES TORONTO GET ALL THE VACCINE DOSES, TORONTO GETS EVERYTHING, WHY DOESN'T NORTH BAY GET VACCINES, I UNDERSTAND. YOU HAVE TO BALANCE THAT NEED FOR AT LEAST THE APPEARANCE OF EQUITY AGAINST THE NEED TO CONTROL THE EMERGENCY. SO THAT'S A COMPLICATED EQUIVOCAL ANSWER I GAVE YOU BUT IT IS COMPLICATED.

Nam says ON THE FLIP SIDE, THERE HAVE BEEN REPORTS THAT PEOPLE WHO DON'T LIVE IN TORONTO HAVE BEEN GETTING VACCINES ARE SUPPOSED TO BE FOR PEOPLE IN TORONTO BECAUSE THEY MIGHT BE FRONT LINE WORKERS BUT THEY DON'T LIVE IN TORONTO, THEY LIVE OUTSIDE OF THE GTA. WHEN YOU DO LOOK AT THE NUMBERS, ASHLEIGH, DOES IT MAKE SENSE TO MAYBE TARGET THE HOT ZONES FIRST? IF WE WANT TO GET THESE NUMBERS DOWN?

Ashleigh says YEAH, I MEAN I THINK IT'S A COMBINATION. I THINK WE WANT TO PROTECT THE MOST VULNERABLE. AND WHAT PREDICTS THE LIKELIHOOD THAT YOU GET REALLY SICK FROM COVID OR THAT YOU DIE, THE MOST OBVIOUS RISK FACTOR IS AGE. BUT LOOK, WHERE YOU LIVE IS ALSO ASSOCIATED WITH THAT RISK. AND SO, YOU KNOW, I THINK OUR INITIAL FOCUS WAS RIGHTLY ON GETTING THIS INTO LONG-TERM CARE HOME RESIDENTS. AND, YOU KNOW, IN GETTING THIS INTO OUR ELDER POPULATION. I DO THINK THAT TARGETING THE RISK AREAS, THESE HIGH-RISK AREAS IT DOES MAKE A LOT OF ZONES BUT IT NEEDS TO BE DONE IN A WAY THAT WITH ANY SORT OF PRIORITIZATION IT'S DIFFICULT BECAUSE WE HAVE A SCARCE RESOURCE THAT EVERYBODY WANTS. SO YOU HAVE TO MAKE SURE THAT... YOU HAVE TO MAKE THESE DIFFICULT DECISIONS. BUT I DO THINK THAT THIS IDEA OF, YOU KNOW, RECOGNIZING THAT RISK ISN'T DISTRIBUTED EQUALLY ACROSS THE PROVINCE. AND THAT MAKING SURE THAT THE PEOPLE THROUGHOUT THIS PANDEMIC HAVE BEEN AT INCREASED RISK AND HAVE BEEN OUT DOING ESSENTIAL ANDREA GONZALEZ PUTTING THEMSELVES BASICALLY ON THE FRONT LINES SHOULD HAVE ACCESS TO THE VACCINE.

Nam says THE U.S., THERE SEEMS TO BE THIS KIND OF... WELL, PEOPLE IN CANADA ARE VERY ENVIOUS OF WHAT'S HAPPENING IN THE U.S. BECAUSE THEY THINK ALL ADULTS ARE SUPPOSED TO BE VACCINATED BY MAY. I THINK, MAY OR JUNE. AND CANADA LOST ITS CAPACITY TO MANUFACTURE ITS OWN VACCINES DECADES AGO AND WE'VE SEEN THE NEGATIVE EFFECTS OF HAVING TO RELY ON OTHER COUNTRIES. WHAT LESSONS HAVE WE LEARNED ABOUT VACCINE SOVEREIGNTY THROUGH THIS PANDEMIC?

Raywat says THERE'S SO MUCH TO UNPACK HERE. WE'LL BE TALKING ABOUT THIS FOR YEARS WHEN THIS IS OVER. SO LOSING THE ABILITY TO MANUFACTURE VACCINES HAS REALLY CRIPPLED OUR ABILITY, I THINK, TO GET SUFFICIENT DOSES INTO CANADIAN ARMS AS QUICKLY AS WE K AND I'M GLAD THAT WE'RE FOCUSED NOW ON REBUILDING THAT COMPARES AT THIS TO SOME LARGE EXTENT. NUMBER ONE WE'RE GOING TO HAVE TO CREATE BOOSTERS. IF NOT THIS YEAR THEN NEXT YEAR. AS THE VARIANTS EMERGE SOME WILL ESCAPE OUR CURRENT VACCINES SO WE SHOULD ALL LINEUP AND GET THE BOOSTERS. AND WE WILL WIN THAT ARMS RACE BECAUSE WE HAVE THE ABILITY TO DO SO. THE ABILITY TO PRODUCE BOOSTERS FOR OUR OWN COUNTRY IS IMPORTANT. THE ABILITY TO HAVE LIVE VACCINE PLATFORMS FOR THES USING MRNA TECHNOLOGY, VIRAL METRAL TECHNOLOGY INCREASES OUR SPECIES TO RESPOND FASTER AND TO PREVENT THIS LEVEL OF GLOBAL EMERGENCY. THAT'S THE ONE THING... WELL, ONE OF MANY THINGS WE'VE LEARNED FROM THIS IS HAVING THE ABILITY TO PIVOT QUICKLY AND TO CREATE NEW TREATMENTS AND VACCINES AND PREVENTIVES IS ESSENTIAL FOR OUR WHEREWITHAL AND OUR ECONOMY. PAIR THAT WITH THE NEED TO INVEST IN SURVEILLANCE. GLOBAL AND LOCAL DISEASE SURVEILLANCE. TO KEEP AN EYE ON PLACES WHERE PEOPLE ASSOCIATE WITH ANIMALS INTIMATELY. BECAUSE THAT'S WHERE THESE THINGS TEND TO ARISE, DISEASES WHERE DISEASES JUMP FROM ANIMAL POPULATIONS TO HUMAN POPULATIONS. WE CAN DO THAT TO AN EXTENT BY INCREASING GLOBAL CAPACITY. NOW THERE IS A GLOBAL THIRST FOR THIS. AND IT IS INEXPENSIVE COMPARED TO THE RESPONSES YOU WOULD NEED TO ENACT IF IT GETS OUT OF CONTROL. VACCINE PLATFORMS AND INCREASED SURVEILLANCE I THINK WILL PAY GREAT DIVIDENDS DOWN THE ROAD.

Nam says ASHLEIGH, I WOULD LIKE YOUR THOUGHTS ON THAT, TOO.

Ashleigh says I AGREE. I THINK THE ABILITY TO MANUFACTURE VACCINES IS GOING TO BE INCREASINGLY IMPORTANT. WE SAW WHAT A MISTAKE IT WAS DURING THIS PANDEMIC. AND YOU KNOW THE IMPORTANT THING TO REMEMBER IS THAT IT BENEFITS NOT ONLY US BUT ALSO THE REST OF THE WORLD, THE MORE PLACES THAT CAN QUICKLY SCALE UP AND MANUFACTURE VACCINES SEEMS THAT EVERYBODY CAN HAVE ACCESS TO VACCINES. WE'RE SO FOCUSED ON WHAT'S HAPPENING IN ONTARIO AND WHAT'S HAPPENING IN THE UNITED STATES. BUT WE NEED TO REMEMBER THAT WE HAVE AN ENTIRE POPULATION AROUND THE WORLD THAT WE NEED TO VACCINATE. AND SO HAVING MORE COUNTRIES WITH THE CAPACITY TO MANUFACTURE VACCINES IS GOING TO BE CRITICAL. YOU KNOW, AS WE NAVIGATE THIS PANDEMIC, AS WE FIGURE OUT, YOU KNOW, WHAT SORT OF BOOSTERS WE NEED IN THE COMING YEARS AND AS WE PREPARE FOR FUTURE HEALTH THREATS.

Nam says WHY SHOULD PEOPLE... BECAUSE I THINK WE HAVE MAYBE PART OF THE MEDIA HAS BEEN DOING THIS A LOT. WE HAVE THE VACCINE, OUR LIVES CAN GO BACK TO NORMAL. BUT ASHLEIGH, ONCE WE DO GET THE VACCINES WHY SHOULD WE... WHAT SHALL WE KEEP IN MIND ABOUT HOW THIS VIRUS OPERATES?

The caption changes to "What's a pandemic to do next?"

Ashleigh says SO, YOU KNOW, I THINK EVERYBODY IS SO EXCITED ABOUT THE IDEA OF GETTING VACCINATED. AND PUTTING IT BEHIND US THAT I THINK THE ONE THING WE'VE LEARNED FROM THIS VIRUS IS THAT IT'S NOT THAT PREDICTABLE. I MEAN ON THE ONE HAND IT'S PREDICTABLE. IT IS A NEW VIRUS. OUR POPULATION DIDN'T HAVE ANY IMMUNITY TO IT AND IT WREAKED A LOT OF HAVOC. BUT IT ALSO, THE VARIANTS OF CONCERN WAS SOMETHING THAT, YOU KNOW, ON THE ONE HAND YOU MIGHT HAVE PREDICTED. BUT THE SPEED WITH WHICH THEY BECAME AN ISSUE I DON'T THINK ANYBODY REALLY ANTICIPATED. AND SO WE HEAR A LOT OF TALK ABOUT THIS BEING A RACE BETWEEN VACCINES AND THE VIRUS AND THESE VARIOUS CONCERNS. BUT I THINK IT'S MORE A GAME OF STRATEGY WHERE, YOU KNOW, THE VIRUS SEEMS TO HAVE THIS ABILITY TO OUT SMART US. NOT TO BE MORBID BUT I THINK WE HAVE THIS SENSE OF CONFIDENCE THAT WE'VE FINALLY OUT SMARTED IT, YOU KNOW, IT CHANGES, IT MUTATES. IT HAS THIS BASICALLY... IT'S A BIT OF A RACE. AND IT'S A BIT OF A GAME. SO I THINK WE NEED TO THINK BEYOND THE NEXT COUPLE MONTHS AND THINK ABOUT, YOU KNOW, HOW DO WE MAKE SURE THAT, YOU KNOW, AGAIN, YOU THINK PEOPLE WILL BELIEVE BECAUSE THIS ISN'T GOING TO GO AWAY UNTIL THE ENTIRE WORLD IS VACCINATED. BUT ALSO THINK ABOUT, YOU KNOW, HOW DO WE MONITOR FOR ANY NEW VARIANTS THAT EMERGE? HOW DO WE MONITOR OUR INDIVIDUAL IMMUNITY OR HOW FREQUENTLY DO WE NEED TO GET BOOSTED FOR THIS? AND, AGAIN, YOU KNOW, LOOKING BEYOND SARS COVI-2 AND HOW DO WE MONITOR FOR FUTURE PANDEMICS BECAUSE THIS IS NOT GOING TO BE THE LAST ONE.

Nam says WE'RE IN A THIRD WAVE. I WANT TO CIRCLE BACK TO THE THIRD WAVE. PARTS OF ONTARIO ARE WE OPENING. THERE HAVE BEEN CALLS FOR ANOTHER LOCK DOWN I THINK UP TO A MONTH. THAT'S THE NUMBER THAT HAS BEEN SUGGESTED. HOW REALISTIC IS THAT, RAYWAT, CONSIDERING THE ECONOMIC CHALLENGES THAT A LOT OF BUSINESSES HAVE EXPERIENCED AND THE POLITICAL WILL?

Raywat says I DON'T SEE A LOT OF WILL FOR IT, TO BE HONEST. AT LEAST NOT AT THE PROVINCIAL LEVEL. I THINK IN CERTAIN HOT ZONES IT'S GOING TO HAPPEN FOR SURE. I THINK IT SHOULD HAPPEN ACROSS THE BOARD BECAUSE THAT'S OUR BEST WAY TO STOP IT QUICKLY. AND WHEN WE STOP IT QUICKLY BY THE WAY IT'S STOPPED FOR GOOD MORE OR LESS. I DON'T ANTICIPATE ANY FURTHER ECONOMIC RESTRICTIONS AFTER THIS SPRING AS VACCINATION ROLLS OUT IN EARNEST. BUT I DON'T SEE THE POLITICAL OR PUBLIC WILL TO ENACT A PROVINCIAL WIDE RESTRICTION. SO IT'S GOING TO BE A REGION BY REGION AFFAIR. HAVING SAID THAT, THERE ARE THINGS WE CAN DO TO MAKE SURE THAT THIS REGION BY REGION AFFAIR IS MORE IMPACTFUL THAN IT COULD BE OTHERWISE. WE COULD REALLY RAMP UP OUR TESTING AND ISOLATION. AND EVERY CITIZEN HAS IT IN OUR POWER TO VOLUNTARILY RESTRICT OUR CONTACTS. THAT'S PROBABLY THE BEST WAY I THINK THAT INDIVIDUALS CAN COP TRIBUTE TO THIS. YOU DON'T HAVE TO GO TO THE RESTAURANT EVEN THOUGH THE RESTAURANT'S OPEN. YOU DON'T HAVE TO GO TO THE GYM BECAUSE IT'S OPEN AND I FEEL BAD FOR RESTAURANTS AND BUSINESS OWNERS SAYING THAT BUT WE CAN STILL MINIMIZE THE EXPOSURE AND SLOW THE DISEASE PROCESS EVEN THOUGH THINGS ARE...

Nam says HOW REALISTIC IS IT TO SAY THAT WHEN IT'S BEEN A YEAR ALREADY AND I THINK FOR... THERE'S A LOT OF PEOPLE WHO WOULD SAY I'VE DONE EVERYTHING RIGHT FOR THE PAST YEAR, I CAN'T DO THIS ANYMORE?

Raywat says IT'S HARD. I LIKEN THIS TO THE THIRD ACT OF AN ACTION MOVIE IN THE THIRD ACT YOU FIGHT THE BIGGEST FOE. OFTEN TIMES IT'S NOT THE FIERCEST FOE IT'S BECAUSE WE'RE QUITE TIRED BUT IT IS THE THIRD ACT. WHICH MEANS WHEN THIS IS DONE THINGS GET EASIER. THERE ARE ALSO SEQUELS THAT I KNOW NO ONE EVER WATCHES AND THAT NEW VARIANT EMERGES, WHATEVER. BUT THE BULK OF THE CRISIS WILL BE DONE SOON. AND SO I THINK THIS IS THE FINAL THING WE'RE ASKING YOU TO DO ON THIS SCALE. AFTER THIS IS SIMPLY A MATTER OF SUBMITTING TO BOOSTER SHOTS AND OCCASIONAL SCREENING TESTS AND SO FORTH. BUT IF WE CAN SURVIVE... SURVIVE ISN'T THE RIGHT WORD. IF WE CAN PERSEVERE THE NEXT TWO, THREE MONTHS OF HARDSHIP THE SUN WILL COME UP AND STAY FOR A WHILE.

Nam says I WANT TO LEAVE ON A MOMENT OF HOPE EVEN JUST REFLECTION. ASHLEIGH OVER THE PAST YEAR WHAT HAS MADE YOU HOPEFUL ABOUT THE CURRENT PREDICAMENT THAT WE'RE IN?

Ashleigh says FAR AND AWAY THE VACCINES ARE THE GOOD NEWS STORY. I REMEMBER A YEAR AGO DOING THE MODELING FOR TWO YEARS AND WE WERE SHOWING THESE RESTRICTIONS IN PLACE FOR TWO YEARS AND I REMEMBER HAVING THIS SENSE OF, YOU KNOW, PEOPLE WERE TALKING ABOUT A VACCINE BUT I REALLY DIDN'T THINK IT WAS REALISTIC. AND, YOU KNOW, HERE WE'RE A YEAR LATER. WE HAVE MULTIPLE VACCINES. WE'VE GONE THROUGH A REALLY INCREDIBLY DIFFICULT YEAR. BUT, YOU KNOW, WE'RE AT A POINT NOW WHERE THERE IS AN END IN SIGHT. WHERE VACCINES REALLY ARE GOING TO CHANGE THE GAME. THEY'VE ALREADY CHANGED THE GAME IN TERMS OF PROTECTING RESIDENTS IN LONG-TERM CARE HOMES. AND I THINK THIS... AS TERRIBLE AS THIS PANDEMIC HAS BEEN IT'S ALSO SHOWN HOW REMARKABLE SCIENCE IS AND HOW IT REALLY CAN STEP UP AND HELP US.

Nam says AND RAYWAT? SAME QUESTION.

Raywat says I HAVE TWO POSITIVE TAKE AWAYS. FIRST IS, AS ASHLEIGH MENTIONED THE MRNA VACCINES ARE A GAME CHANGER. WE CAN USE THESE FOR CANCER, EBOLA, HIV, POSSIBLY. ALL KINDS OF POSSIBILITIES ARE OPEN TO US NOW. IN ADDITION AS NEW VARIANTS ARISE WE WILL WIN THE ARMS RACE BECAUSE THE MRNA TAKES 48HOURS TO CREATE AND SEQUENCE THE GENE SIX WEEKS TO DEVELOP AND UP TO SIX WEEKS TO PUT IN PRODUCTION. THAT'S AN ENORMOUS SPEED OF RESPONSE THAT THE HUMAN SPECIES NOW HAS IN COMBATING A DISEASE LIKE THIS. THE SECOND THING IS THE THIRST FOR SCIENCE LITERACY AND EDUCATION. THIS HAS BEEN A FAILURE OF WESTERN CIVILIZATION FOR THE LAST COUPLE OF DECADES. WE'VE RETREATED FROM THE DESIRE TO LEARN THE HARD THINGS... THE DESIRE TO LEARN THE HARD THINGS. AND NOW PEOPLE HAVE AWOKEN TO THE FACT THAT WE HAVE A CRISIS OF NUMERACY AND LITERACY. AND I'M EXCITED TO THE PART OF THE REAWAKENING.

Nam says LOOKING BACK ON THE PAST YEAR WHAT MAKES YOU SAY, ASHLEIGH, HUH, I NEVER SAW THAT COMING?

The caption changes to "Coronavirus: Then and now."

Ashleigh says THERE IS A LOT I DIDN'T SEE COMING. I THINK, YOU KNOW, AGAIN I JUST SAID, WE RAN THIS OUT FOR TWO YEARS. AND SO I KNEW THAT WE WERE GOING TO BE IN THIS FOR THE LONG HAUL. BUT ACTUALLY LIVE BEING THROUGH THIS AND LIKE THE LENGTH OF TIME AND HOW TIME PEOPLES SIMULTANEOUSLY REALLY FAST AND REALLY SLOW AND SORT OF THE FATIGUE THAT EVERYONE FEELS, YOU KNOW, YOU CAN COME UP WITH THE SORT OF MODELS THAT SAY WELL, WE JUST NEED TO DO THIS FOR SIX MONTHS OR FOR THREE WEEKS. BUT THE REALITY OF THAT ACTUALLY IMPLEMENTING AND THIS SORT OF LACK OF POLITICAL WILL AND POLITICAL SUPPORT FOR SOME OF THE HARD WORK THAT WE NEEDED TO DO WAS SOMETHING THAT, YOU KNOW, I CERTAINLY WOULDN'T HAVE PREDICTED LAST JANUARY.

Nam says RAYWAT, I WILL GIVE YOU THE LAST MINUTE.

Raywat says THE BARRIER IN RESPONDING TO THIS PANDEMIC WASN'T RESOURCES. IT WASN'T THE VIRUS. IT WASN'T ANYTHING TECHNICAL. SCIENCE GAVE US VACCINES IN UNDER A YEAR, THE BARRIER WAS PEOPLE AND I WAS SURPRISED BY THAT. AND PEOPLE PRESENTED PROBLEMS IN TERMS OF POLITICAL WILL. IN TERMS OF ACTIVE DISINFORMATION, IN TERMS OF ACTUAL THREATS TOWARD PUBLIC HEALTH OFFICIALS. IT'S BEEN A SADDENING TO WATCH. HOW WE ARE OUR WORST ENEMIES AND THAT MEANS WE NEED TO REINVEST IN CIVIC RESPONSIBILITIES. MORE SO THAN SCIENTIFIC WHEREWITHAL. SO THIS HAS ALWAYS BEEN A CRISIS THAT TURNS OUT OF THE HUMAN WILL AND THE HUMAN CHARACTER. AND NOW WE CAN DODGETATE UPON THAT TRUTH THE NEXT COUPLE OF YEARS AND WONDER WHAT WE DID WRONG AND WHERE CAN WE GO BETTER.

The caption changes to "Producer: Liane Kotler, @LianeKotler."

Nam says JUST TO WRAP UP WITH WHAT ASHLEIGH SAID WE'RE ALL IN THIS TOGETHER. IF ONE OF US HAS THIS, NONE OF US ARE SAFE. AS ALWAYS, I LEARN SO MUCH FROM BOTH OF YOU. THANK YOU SO MUCH FOR SHARING YOUR INSIGHT. WE APPRECIATE YOU MAKING TIME FOR US BECAUSE I KNOW YOUR SCHEDULES ARE VERY, VERY BUSY. THANK YOU SO MUCH.

The caption changes to "Subscribe to The Agenda Podcast: tvo.org/theagenda."

Raywat says THANK YOU VERY MUCH.

Ashleigh says THANK YOU.

Watch: Tracking Ontario's Progress Against Covid-19