Transcript: Can Vaccines Get Us Back to Normal? | May 14, 2021

Nam sits in a room with gray walls and a bookcase in the background. She's in her early forties, with shoulder length straight brown hair. She's wearing glasses, a black blazer over a striped white shirt, and a silver pendant necklace.

A caption on screen reads "Can vaccines get us back to normal? Nam Kiwanuka, @namshine, @theagenda."

Nam says MOSTLY THE NEWS AROUND VACCINES IS GOOD AND GETTING BETTER. THERE ARE MORE OF THEM AND MORE PEOPLE ARE ELIGIBLE TO RECEIVE THEM. BUT, AFTER THE ASTRAZENECA VACCINE WAS PAUSED THIS WEEK, THOSE WHO GOT THEIR FIRST DOSE OF IT HAVE LOTS OF QUESTIONS. AND ALL OF US WANT TO KNOW, ARE WE ALMOST AT THE END OF THIS? HERE TO HELP POINT THE WAY: IN GUELPH, ONTARIO: DR. KATE MILLER, FAMILY PHYSICIAN AND AN ASSISTANT CLINICAL PROFESSOR AT MCMASTER UNIVERSITY'S DEPARTMENT OF FAMILY MEDICINE...

Kate is in her thirties, with long straight brown hair. She's wearing glasses and a black blouse.

Nam continues AND HERE IN ONTARIO'S CAPITAL CITY: MARIA SUNDARAM, INFECTIOUS DISEASE EPIDEMIOLOGIST AT I.C.E.S., FORMERLY KNOWN AS THE INSTITUTE FOR CLINICAL EVALUATIVE SCIENCES...

Maria is in her thirties, with long straight brown hair. She's wearing a black sweater.

Nam continues AND TIM SLY, PROFESSOR EMERITUS AT RYERSON UNIVERSITY'S SCHOOL OF OCCUPATIONAL AND PUBLIC HEALTH...

Tim is in his late fifties, with short gray hair and a goatee. He's wearing glasses, a beige suit and a blue shirt.

Nam continues HI TO YOU ALL. MARIA, I WANT TO START WITH YOU. YOU KNOW, AT FIRST ASTRAZENECA MILLIONS IN THE U.K. GOT VACCINATED. AFTER REPORTS OF RARE BLOOD CLOTS IN YEAR, DISTRIBUTION WAS SUSPENDED AND THEN IT WAS DEEMED SAFE. AND IN ONTARIO A BUNCH OF GEN-XERS LIKE MYSELF RAN OUT TO GET THE VACCINE AS THE AGE GROUP WAS LOWERED AS THOSE IN THE OLDER GROUPS WEREN'T TAKING IT. THE MESSAGE AT FIRST WAS GET THE FIRST VACCINE YOU'RE OFFERED. AND THEN THE NATIONAL ADVISORY COMMITTEE ON IMMUNIZATION, NACI, SAID IF YOU PREFER TO WAIT AND YOU'RE NOT A FRONT LINE WORKER AND YOU'RE NOT LIVING IN A HOT ZONE, YOU COULD DO THAT AND GET THE VACCINE THAT YOU WANTED. NOW ONTARIO HAS DECIDED NOT TO ADMINISTER ANY MORE FIRST DOSES OF THE ASTRAZENECA VACCINE. WHEN YOU HEAR ALL THAT, HOW DID WE GET TO WHERE WE ARE RIGHT NOW?

The caption changes to "Maria Sundaram. ICES."

Maria says THAT'S A GREAT QUESTION, ESPECIALLY WHEN IT'S LAID OUT LIKE THAT, THAT SOMEONE NOT FOLLOWING THIS CLOSELY, SOMEONE WHO IS NOT A VACCINES EPIDEMIOLOGIST LIKE MYSELF, PEOPLE WOULD SAY PEOPLE DON'T KNOW WHAT THEY'RE DOING AND THEY DON'T KNOW WHAT THEY WANT. THAT'S FAR FROM THE TRUTH BUT I CAN UNDERSTAND HOW YOU WOULD ARRIVE AT THAT CONCLUSION. SO WHAT WE'RE TRYING TO DO IS EXPLAIN THE RISK AND THE BENEFIT OF THESE VACCINES IN A CHANGING ENVIRONMENT. IMAGINE HOW, YOU KNOW, WE ROLLED THIS VACCINE OUT IN THE U.K. AND WE DIDN'T IDENTIFY ANY SAFETY CONCERNS AMONG OLDER PEOPLE BECAUSE THIS BLOOD CLOT THAT'S VERY RARE IS ALSO, YOU KNOW, EVEN LESS COMMON IN OLDER PEOPLE. SO AS WE RATCHETED THE AGE DOWN, WE SAW THE POTENTIAL RISK OF THAT INCREASE. BUT WE ALSO WERE ADMINISTERING THIS VACCINE IN AN ENVIRONMENT WHERE THERE WAS REALLY HIGH COMMUNITY LEVEL TRANSMISSION, ESPECIALLY HERE IN THE GTA. AND SO THEN IT WAS KIND OF LIKE THIS WEIGHING OF THE RISK AND BENEFIT WHERE, YOU KNOW, THERE WAS A VERY SMALL RISK OF THIS POTENTIALLY SERIOUS OUTCOME, BUT THEN THE MUCH GREATER RISK OF POTENTIALLY BEING HOSPITALIZED FOR COVID-19, AND WE ALSO KNOW THAT COVID-19 HAS WITH IT A RISK OF BLOOD CLOTS, NOT THE SAME KIND, BUT A HIGHER RISK OF BLOOD CLOT IF YOU HAVE COVID-19 VERSUS IF YOU GET A VACCINE. WHAT WE'RE SEEING IS THIS CHALLENGE OF WEIGHING THIS KIND OF RISK AND BENEFIT.

Nam says THE MESSAGE THAT PEOPLE HEARD WAS, YOU KNOW, GET THE FIRST VACCINE THAT YOU'RE OFFERED. AND A LOT OF PEOPLE, YOU KNOW, RAN OUT TO GET THE ASTRAZENECA VACCINE, AND WHEN THE NEWS CAME OUT THIS PAST WEEK THAT IT WAS BEING PAUSED IN ONTARIO, YOU KNOW, I THINK THERE WAS A FEELING OF, WE TRY TO DO THE RIGHT THING, AND THIS BLOOD CLOT IS RARE, BUT WE DID TRY TO DO THE RIGHT THING AND NOW WE JUST KIND OF FEEL, I DON'T KNOW, MAYBE BETRAYED, MAYBE MISLED. CAN YOU SEE WHY FOR PEOPLE WHO ARE NOT AN EPIDEMIOLOGIST, WHO MIGHT THINK THAT, YOU KNOW, THE PEOPLE IN CHARGE ACTUALLY DON'T KNOW WHAT THEY'RE DOING?

The caption changes to "Maria Sundaram, @mariasundaram."

Maria says I CAN TOTALLY UNDERSTAND WHY PEOPLE WOULD FEEL THAT WAY AND I ESPECIALLY UNDERSTAND THAT GIVEN THE CONTEXT OF THIS WORDING AROUND THE PREFERRED VACCINE VERSUS THE NOT PREFERRED VACCINE WHICH HAS LIKE A VERY SPECIFIC SCIENTIFIC MEANING AND THEN ALSO KIND OF A VERY SLIGHTLY DIFFERENT COLLOQUIAL MEANING. YOU WOULD FEEL LIKE, OKAY, YOU TOLD ME TO GO GET A VACCINE AND I GOT A VACCINE THAT MAYBE WASN'T PREFERRED AND NOW YOU'RE TELLING ME NOT TO GET IT AT ALL. WHAT DO YOU WANT ME TO DO? THAT'S COMPLETELY UNDERSTANDABLE AND KIND OF A LOGICAL CONCLUSION TO DRAW FROM WHAT HAS HAPPENED. THE BEST I CAN SAY HERE IS, IF IT WERE ME, I WOULD HAVE BEEN REALLY HAPPY TO GET THE ASTRAZENECA VACCINE, AND IF IT WERE STILL AVAILABLE TODAY, I'D STILL PROBABLY GET IT TODAY IF IT WERE AVAILABLE TO ME. THE RISK OF THE BLOOD CLOTS IS QUITE A BIT LOWER FOR SECOND DOSE OF ASTRAZENECA. SO HOPEFULLY THE PEOPLE WHO HAVE ALREADY HAD ONE DOSE OF ASTRAZENECA, YOU'RE ALREADY OUT OF THE WOODS AND YOU'LL BE ABLE TO GET A SECOND DOSE, FINGERS CROSSED, LATER THIS SUMMER.

Nam says TIM, LET'S TALK ABOUT RISK, BECAUSE I THINK WHEN PEOPLE DID HEAR THE NEWS, AND I POSED THE QUESTION ON TWITTER: WOULD YOU STILL GET THE ASTRAZENECA VACCINE FOR YOUR SECOND DOSE, KNOWING WHAT YOU KNOW NOW. AND PEOPLE ARE SAYING I'D RATHER TAKE THE RISK OF GETTING THE VACCINE AS OPPOSED TO EXPOSING MYSELF AND MY COMMUNITY TO THE POTENTIAL OF GETTING COVID. SO HOW MUCH OF THIS STORY, TIM, IS ABOUT RISK ANALYSIS?

The caption changes to "Tim Sly. Ryerson University."

Tim says IT'S ACTUALLY MORE CONCERNED WITH THE RISK PERCEPTION. WE DO THE ANALYSIS VERY WELL, NUMBER-CRUNCHING. THERE'S NO SHORTAGE OF THAT. BUT THE IMPORTANT THING IS PERCEPTION. PERCEPTION IS EVERYTHING. AS A TEACHER EVEN, IT'S VERY IMPORTANT TO BE ABLE TO PUT YOURSELF IN THE BACK ROW AND THAT LITTLE PERSON WHO IS WONDERING IF THEY SHOULD EVEN BE THERE AND TO SAY, WHAT I JUST SAID, HOW IS THAT PERCEIVED BY THAT PERSON? DID IT MAKE SENSE? AND IN THIS PARTICULAR CASE, SOME OF THE GOOD ANALYSIS PROBABLY CONFUSED PEOPLE RATHER THAN HELPED RELAX THEM A LITTLE BIT.

Nam says IN WHAT WAY?

Tim says WELL, WE HAVE TWO REACTIONS TO KNOWING ABOUT RISK. ONE IS IN THE IMMEDIATE VERSION, RUN, TAKE OURSELVES AND RUN AWAY. THE OTHER IS A CALM, RELAXED APPROACH. UNFORTUNATELY, THE IMMEDIATE REACTION KICKS IN RIGHT AWAY. SO IF THEY HEAR ANYTHING, ANY RISK, IT DOESN'T MATTER THE SIZE, HOW MANY ZEROS THERE ARE IN THE SIZE OF THE RISK, IF THERE'S A RISK THERE, LET'S GO THE OTHER DIRECTION. YET THEY DID THE RIGHT THING. YOU AND I, MANY OF MY FAMILY HAS TAKEN THE ASTRAZENECA VACCINE AND I WOULD STILL ENCOURAGE THEM TODAY. IT'S A REMARKABLY GOOD VACCINE. IT'S PROBABLY BETTER THAN WE WOULD HAVE SUSPECTED AT THE END OF THE PHASE 3 TRIALS. BUT IT DOES HAVE THIS SMALL... REMEMBER, FOUR WEEKS AGO IS NOT WHERE WE WERE LAST WEEK. FOUR WEEKS AGO, ALL THE INDICATORS WERE GOING IN THE WRONG DIRECTION. EVERYTHING WAS LOOKING PRETTY BAD. HOSPITALS WERE GETTING READY FOR TRIAGE, SOMETHING WE DIDN'T EVER EXPECT TO DO HERE. IN THE LAST SEVEN DAYS, THINGS HAVE CHANGED QUITE DRAMATICALLY. AND SO THE ANALOGY IS A LITTLE BIT LIKE THE SHIP IS NOW MOVING TOWARD THE ROCKS, WE PROBABLY WILL HIT THE ROCKS AT SOME POINT. GRAB A LIFE BELT. IT DOESN'T MATTER WHETHER IT FITS PERFECTLY, IT DOESN'T MATTER WHERE THE WHISTLE IS BLOWING, BUT GRAB THE LIFE JACKET. THAT WAS GOOD ADVICE. NOW WE'VE NEGOTIATED ROUND THEM. THE RISK OF HITTING THEM IS LESS. WE CAN SAY CHOOSE A REALLY GOOD LIFE JACKET, CHOOSE IT PROPERLY AND THE WHISTLE WORKS, DIFFERENT MESSAGE, AND IT WAS APPROPRIATE AT THE TIME TO SAY THAT.

Nam says YOU MENTIONED THAT THIS IS MORE ABOUT PERCEPTION OF RISK, RISK PERCEPTION. YOU KNOW, ARE WE AS HUMAN BEINGS NATURALLY GOOD AT RISK ANALYSIS OR IS IT SOMETHING THAT WE NEED TO BE TAUGHT?

says WE IN CANADA HAVE DONE... WE'VE PRODUCED SOME OF THE RISK ANALYSIS PEOPLE. BUT WE HAVEN'T REALLY DONE, NOR HAS ANYONE ELSE IN THE WORLD, DONE A REALLY GOOD JOB AT RISK COMMUNICATION. THERE'S LONG LITERATURE ON THIS. I'M PARTICULARLY INTERESTED IN HOW WE'VE DONE. IF WE LOOK BACK AT SOME OF THE MISTAKES THAT WERE MADE FOR 2003, SARS I, LOOK AT HOW JUSTICE CAMPBELL WROTE THAT WONDERFUL REPORT IN 2006. HE SAID, SHOULD ONTARIO BE FACED WITH ANOTHER HEALTH HAZARD IN THE SAME WAY, LET'S HOPE THAT WE DON'T MAKE THESE FOLLOWING SEVEN ERRORS. UNFORTUNATELY, WE SEEM TO HAVE MADE THE SAME MISTAKES AGAIN. WE HAVEN'T LEARNED MUCH FROM THEM AND MANY OF THOSE WERE PERCEPTION PROBLEMS AS WELL. YES, PERCEPTION IS EVERYTHING.

Nam says PERCEPTION IS EVERYTHING. DR. MILLER, SOMETHING THAT'S BEEN TALKED ABOUT DURING THIS PANDEMIC IS THAT FAMILY DOCTORS HAVEN'T BEEN INVOLVED IN THE VACCINE ROLLOUT, YOU KNOW, SO WHEN WE TALK ABOUT RISK ANALYSIS, THE PEOPLE THAT WE... WHO KNOWS US BEST PERHAPS WITH OUR HEALTH, WE HAVEN'T BEEN ABLE TO ENGAGE WITH THEM IN THE SAME WAY. DO YOU THINK THAT THE GOVERNMENT MISSED AN OPPORTUNITY?

The caption changes to "Kate Miller. Family Physician."

Kate says I THINK IT'S FAIR TO SAY WE HAVEN'T [INAUDIBLE] PLANNING WHO AND WHEN AND HOW. BUT WE'VE BEEN VERY INVOLVED IN ALL OF THESE RISK CONVERSATIONS. I DON'T HAVE A CLINICAL APPOINTMENT THESE DAYS THAT DOESN'T INVOLVE A CONVERSATION ABOUT VACCINE IN SOME WAY. BUT CERTAINLY WE ARE THE EXPERTS IN TALKING TO THE PATIENTS. WE KNOW ABOUT THEIR RISK AND THEIR CONTEXT [INAUDIBLE] HOW THE WORLD HAS CHANGED BUT ALSO WHAT RISKS [INAUDIBLE].
[AUDIO DIFFICULTIES]
CARE ABOUT THE COLOUR OF THEIR LIFE BELT. THERE'S MANY FACTORS THAT COME INTO RISK DECISIONS THAT AREN'T JUST THE NUMBERS, THAT AREN'T JUST THE SCIENCE, BUT ALSO WHO YOU ARE, WHAT YOU WORRY ABOUT, WHAT DECISIONS YOU'VE MADE [INAUDIBLE] AND WE'VE BEEN DOING THAT ALL THE WAY THROUGH AND CERTAINLY A LOT OF IT LAST WEEK. PEOPLE EITHER HAD ASTRAZENECA [INAUDIBLE]

Nam says JUST TO FOLLOW UP WITH THAT. THEN HOW DO YOU EXPLAIN RISK ANALYSIS TO YOUR PATIENTS IN A WAY THAT THEY CAN UNDERSTAND WHEN INFORMATION CHANGES SO MUCH?

The caption changes to "Kate Miller, @DrKateMiller."

Kate says PART OF IT I THINK IS EXPLAINING HOW THEY REACHED [INAUDIBLE], RIGHT? WHY IS IT DIFFERENT NOW THAN IT WAS 8 WEEKS AGO OR 4 WEEKS AGO? WHY WE HAVE AN ALTERNATIVE THAT WE MIGHT NOT HAVE HAD. SO ALL OF THAT, GIVING THEM A SENSE OF WHY THE CHANGES HAVE HAPPENED SO THEY HAVE MORE CONFIDENCE IN THE CHANGES. DOES THE SCIENCE LOOK GOOD? I AGREE WITH THE RECOMMENDATIONS OF ASTRAZENECA [INAUDIBLE] WHY DIDN'T YOU MAKE A GOOD DECISION [INAUDIBLE]. HELPING GIVE ANALOGIES, WHETHER IT'S THE LIFE BOAT ANALOGY OR DECISION MAKING WHETHER IT'S OKAY TO GO OUT WHEN THE WEATHER FORECAST HAS A 20 percent CHANCE OF RAIN. THEY DO RISK ASSESSMENTS IN THEIR LIFE ALL THE TIME AND GIVING THEM ANALOGIES. WHAT ARE THE FACTORS THAT MATTER TO THEM MOST? IS IT SAFETY, EFFICACY, OR TIMING? AND PUT IT IN A CONTEXT. CAN YOU PROTECT YOURSELF FROM COVID OR DO YOU HAVE TO GO TO A JOB WHERE THERE IS A FEAR OF BEING EXPOSED AND THAT CHANGES YOUR PERCEPTION.

Nam says MARIA, SOMETHING WE'VE BEEN HEARING A LOT ABOUT HOW WE'RE GOING TO GET TO A POINT WHEREAS COMMUNITIES WE'RE SAFE IS THIS CONCEPT OF HERD IMMUNITY. I THINK FOR A LOT OF US THE FIRST TIME WE MIGHT HAVE HEARD IT WHEN BORIS JOHNSON WAS SAYING THAT'S THE WAY THE U.K. WAS GOING TO DEAL WITH COVID-19 AND MOST EXPERTS SEEM TO THINK IT WAS A BAD STRATEGY. NOW WE'RE HEARING THAT WE'RE AIMING TO GET TO HERD IMMUNITY THROUGH VACCINATION. WHAT DOES HERD IMMUNITY ENTAIL AND CAN WE ACTUALLY GET TO THAT POINT THROUGH VACCINATION?

Maria says THAT'S A GREAT QUESTION. HERD IMMUNITY BASICALLY SAID, LET'S SAY I CAN'T BE PROTECTED AGAINST A PATHOGEN. SO I'M TECHNICALLY AT RISK. EVERY SINGLE PERSON THAT MEANS THAT I'M PROTECTED. SO THAT'S KIND OF WHERE HERD IMMUNITY COMES IN. WE KIND OF HAVE THIS SYNERGISTIC EFFECT, THIS COMMUNITY EFFECT, WHERE WE'RE PROTECTING EACH OTHER BECAUSE MOST OF THE PEOPLE WITHIN THE COMMUNITY ARE PROTECTED. YOU CAN GET THAT FROM A VACCINE. YOU CAN ALSO GET IT IN THEORY FROM NATURAL INFECTION OF CERTAIN DISEASES. THE REASON WHY...

Nam says COVID-19 THEN YOU CREATE HERD IMMUNITY IN THAT WAY?

Maria says IT'S POSSIBLE. THE REASON WHY I SAY IN THEORY IS FIRST OF ALL WE KNOW WITH SOME CORONAVIRUSES THAT YOUR IMMUNITY AGAINST THAT CORONAVIRUS THAT CAUSED MAYBE A MILDER ILLNESS GOES AWAY AFTER A WHILE. SO WE DON'T KNOW HOW LONG YOUR IMMUNITY MIGHT LAST, WE DON'T KNOW HOW ROBUST IT MIGHT BE, AND WE KNOW SPECIFICALLY FOR COVID-19 AND SARS CO-V 2, CANNOT ONLY POSES A PROBLEM TO YOU BUT THE HEALTH CARE SYSTEM AND THAT POSES PROBLEMS TO OTHER PEOPLE WHO MIGHT BE SEEKING CARE BECAUSE THEY WERE IN A CAR CRASH OR BECAUSE THEY HAD A HEART ATTACK. SO THERE ARE THESE KIND OF LIKE... AGAIN THESE COMMUNICABLE RISKS. THE REASON EPIDEMIOLOGISTS PUSH BACK BECAUSE THE IDEA OF HERD IMMUNITY FROM NATURAL INFECTION IS THAT IT POSED TOO MUCH OF A THREAT FIRST OF ALL TO OUR COMMUNITIES, IT WAS A HUGE NUMBER OF PREVENTABLE ILLNESSES AND DEATH WHICH IS ANT ETHICAL TO EPIDEMIOLOGY, AND IT WOULD HAVE SHOOK THE VERY FOUNDATION OF OUR HEALTH CARE SYSTEM AND THAT'S JUST NOT AN ACCEPTABLE RISK. WHEN WE TALK ABOUT VACCINES, WE DO KNOW THAT HERD IMMUNITY IS POSSIBLE TO ACHIEVE FOR SOME VACCINES AND WE THINK IT IS LIKELY POSSIBLE TO ACHIEVE FOR COVID-19 IF WE STILL HAVE REMAINING VERY HIGH VACCINE EFFECTIVENESS AGAINST CIRCULATING VARIANTS. EXISTING EVIDENCE SUGGESTS THAT MAY BE THE CASE, WE DO NEED TO KNOW MORE. AND IF WE GET VERY, VERY HIGH UPTAKE OF THOSE VACCINES.

Nam says SO LOTS OF IF'S, TIM. IF WE DON'T GET TO ALL THE IF'S, WHAT HAPPENS THEN? WHAT HAPPENS IF WE DON'T REACH HERD IMMUNITY?

Tim says WELL, IF YOU LOOK AT WHAT'S HAPPENING IN INDIA RIGHT NOW, TREATMENT AND THE APPROPRIATE ATTENTION IS JUST NOT ABLE TO BE GIVEN TO MOST OF THESE PEOPLE. YOU SEE WHAT WOULD HAPPEN IF YOU JUST LET THE PATHOLOGY CARRYING ON DOING ITS NORMAL ROUTINE... WE WILL GET TO HERD IMMUNITY. IT'S THE WAY ALL PANDEMICS AND EPIDEMICS EVENTUALLY END. THERE IS A COMMON MISUNDERSTANDING, THAT THERE'S SOME KIND OF POLICY YOU COULD BRING. IT'S NOT THE POLICY. IT'S A NATURAL PROGRESSION. BUT WHAT YOU SEE IN INDIA IS WHAT WOULD HAPPEN IF YOU JUST LET IT GO, WHAT PEOPLE ARE SAYING, JUST LET EVERYBODY BECOME INFECTED AND IF THEY SURVIVE, THEY SURVIVE, IF THEY DIE, THEY DIE. AND WHOEVER IS LEFT WILL BE IMMUNE. THAT'S A CLUMSY WAY OF DOING IT. THAT'S ACTUALLY WHAT HAPPENED IN 1918 BECAUSE WE DIDN'T HAVE TREATMENT OR TESTS OR ANYTHING ELSE. NOW WE HAVE VACCINES TO THE RESCUE. SO THIS IS THE WAY TO GO. SO WE NEED TO REACH THAT. AND WE HAVE SEEN... IT'S WONDERFUL TO SEE THE PUBLIC NOW TALKING ABOUT THINGS THAT EPIDEMIOLOGISTS WERE KEEPING TO THEMSELVES, LIKE HERD IMMUNITY, TRANSMISSION THRESHOLD AND SO ON. BUT WE'VE HAD TO SEE A CHANGE, AN INCREASE IN HERD IMMUNITY BECAUSE OF THE VARIANTS. THE ORIGINAL ONE WE WERE DOING THE CALCULATIONS, SOMEWHERE AROUND 61 percent, ROUGHLY, VERY ROUGHLY, OF THE COMMUNITY WOULD NEED TO BE IMMUNE TO STOP THE THING SPREADING. NOW THAT'S BOOSTED UP TO THE LOW 70S NOW. BUT WE COULD STILL GET THERE. WE'RE MOVING TOWARD THAT.

Nam says MARIA, TIM MENTIONED THE VARIANTS. WHY IS THE SPEED OF IMMUNIZATION IMPORTANT WHEN IT COMES TO HERD IMMUNITY?

Maria says THE WAY THAT I LIKE TO THINK ABOUT THIS, AND I HOPE THIS IS HELPFUL FOR LISTENERS AND VIEWERS, IS THE REASON THAT YOU WANT TO INVEST IN LIKE A RETIREMENT ACCOUNT EARLIER ON. THE SAME AMOUNT OF MONEY THAT YOU INVEST EARLIER ON IS WORTH WAY MORE AT THE END THAN THAT SAME AMOUNT OF MONEY WHEN YOU INVEST IT 10 OR 20 YEARS LATER. THE REASON FOR THIS WHEN IT COMES TO PUBLIC HEALTH IS THE NUMBER OF ILLNESSES YOU CAN PREVENT TODAY MEANS THAT YOU PREVENTED DOUBLE THAT NUMBER OF ILLNESSES IN THE FOLLOWING WEEK OR IN THE DUPLICATION PERIOD, THE FEWER TRANSMISSION EVENTS THAT WE HAVE, THE LESS LIKELIHOOD WE HAVE THE EMERGENCE OF NEW VARIANTS OF CONCERN, AND THE FEWER CASES THAT WE HAVE, THE MORE RESOURCES WE HAVE TO SORT OF ZERO IN ON THE CASES THAT DO NEED INVESTIGATION, THAT DO NEED CONTACT TRACING. SO WE REALLY ARE BENEFITING SO MUCH FROM ATTACKING THIS AS MUCH AS POSSIBLE AS EARLY AS POSSIBLE.

Nam says YOU KNOW, DR. MILLER, AS A FAMILY DOCTOR, WHAT ROLE DOES VACCINE HESITANCY PLAY IN OUR ABILITY TO THE PATIENTS THAT YOU SEE, HOW DO YOU TALK TO THEM ABOUT THAT AND HAVE YOU HEARD FROM YOUR PATIENTS WHO MIGHT BE MORE HESITANT TO GET A VACCINE AFTER THIS PAUSE IN THE ASTRAZENECA ANNOUNCEMENT?

Kate says I THINK MOST OF US ARE SEEING THE MAJORITY OF OUR PARENTS ARE REALLY EAGER FOR VACCINATIONS, RIGHT? IT'S BEEN A HARD, LONG YEAR. THEY KNOW VACCINES IS ONE OF OUR BEST WAYS OUT OF IT. ALL OF US HAVE A SMALL GROUP OF PEOPLE I'M NOT SURE WE'LL EVER BE ABLE TO TALK INTO VACCINES. THAT'S THE GOOD THING ABOUT HERD IMMUNITY. THE PATIENTS ON THE FENCE, THEY HAVE QUESTIONS OR HESITANCY BECAUSE THEY'RE WORRIED IT'S HAPPENING TOO QUICKLY, BECAUSE ASTRAZENECA HAS DEFINITELY MADE EVERYONE A LITTLE MORE APPREHENSIVE, ALTHOUGH IT'S MADE THEM...

[INAUDIBLE]
[AUDIO DIFFICULTIES]

Nam says YOU KNOW, I THINK A LOT OF PEOPLE WATCHING THIS AND LISTENING TO THIS WANT TO KNOW WHEN, WHEN ARE WE GOING TO REACH HERD IMMUNITY AND, TIM, YOU SAID WE ARE GOING TO. I'M NOT GOING TO ASK YOU TO LOOK INTO A CRYSTAL BALL OR ANYTHING, BUT IT'S BEEN... WE'RE IN YEAR TWO OF THIS PANDEMIC AND I DON'T KNOW... I THINK PEOPLE HAVE MORE QUESTIONS NOW THAN THEY DID AT THE BEGINNING. I COULD BE WRONG. BUT WHEN YOU GET A SENSE OF LIKE WHEN WE WOULD BE ABLE TO REACH HERD IMMUNITY.

Tim says IT'S BEEN MY CALCULATION 423 DAYS WE'VE BEEN LIVING UNDER THIS DARK CLOUD. BUT I HEARD THIS MORNING SOME... WE NEED SOME EXCELLENT NEWS, SOME GOOD NEWS. AND I HEARD SOMETHING TODAY FROM DR. BONNIE HENRY IN B.C. THAT I THINK SHOULD BE ECHOED ACROSS THE COUNTRY. THAT IN THE LAST COUPLE OF WEEKS, THE PEOPLE WHO HAVE BEEN DIAGNOSED WITH COVID-19, 98 percent WERE NOT VACCINATED AT ALL. 1.7 percent HAD ONE SHOT. AND .2 percent HAD BOTH SHOTS. IN OTHER WORDS, THE OVERWHELMING EVIDENCE IS RIGHT THERE IN FRONT OF US THAT THE VACCINE WORKS AND IT IS THE WAY OUT OF THIS MESS. NOW, WHAT WE HAVE TO AVOID DOING IS THE MISTAKE THAT UNFORTUNATELY WE'VE SEEN IN THIS COUNTRY AND ALL AROUND THE WORLD IS WHEN WE BEGIN TO RELAX THE RESTRAINTS TOO EARLY AND TOO SOON. IT'S STILL NOT BEYOND THE REALMS OF POSSIBILITY, WE COULD GET ANOTHER VARIANT WHICH TRANSMITS AS EFFECTIVELY AS THE 117, THE ONE WE'RE DEALING WITH NOW, BUT ALSO HAS INCREASED PATHOLOGY, LETHALITY, AND ALSO AVOIDS VACCINES. THAT COULD HAPPEN AT ANY POINT. SO LET'S CAREFULLY STAY THE COURSE THAT WE'RE ON BECAUSE THE COURSE WE'RE ON IS THE RIGHT COURSE AND IT'S THE RAPID WAY TO GET OUT OF THIS MESS.

Nam says MARIA, THE CDC ANNOUNCED THIS WEEK THAT FULLY VACCINATED PEOPLE DON'T NEED TO WEAR MASKS ANYMORE, AND THAT'S INDOORS AND OUTDOORS. WHAT DO YOU THINK OF THAT DECISION?

Maria says I THINK IT'S A REALLY INTERESTING DECISION. YOU KNOW, THERE'S A LOT OF CONVERSATION HAPPENING ABOUT, YOU KNOW, WHETHER YOU SHOULD FEEL FREE TO TAKE A MASK OFF AND WHETHER YOU SHOULD PERHAPS PRESSURE PEOPLE WHO ARE STILL WEARING MASKS TO TAKE THEM OFF NOW THAT THEY DON'T NEED TO. MY TAKE ON THIS IS THAT PANDEMICS DON'T END WITH A BANG. WE DON'T JUST WAKE UP ONE DAY, SUDDENLY THE PANDEMIC IS OVER. THEY REALLY END WITH A WHIMPER. AND WHAT WE'VE SEEN FROM EVERY OTHER INFECTIOUS DISEASE THAT EPIDEMIOLOGISTS HAVE TRIED TO PREVENT, THE LAST INCH IS JUST AS HARD AS THE FIRST 100 MILES. AND SO IN MY PERCEPTION, I THINK THERE'S ABSOLUTELY NOTHING WRONG WITH CONTINUING TO WEAR A MASK AND CONTINUING TO BE CAUTIOUS WHILE SORT OF USING THE KNOWLEDGE THAT PEOPLE HAVE LEARNED OVER THE COURSE OF THIS PANDEMIC, THEIR UNDERSTANDING OF HERD IMMUNITY, THEIR UNDERSTANDING OF VACCINE PROTECTION, THEIR UNDERSTANDING OF TRANSMISSIBILITY AND CONTAGIOUSNESS. THOSE ARE REALLY GOOD TOOLS WE HAVE NOW AND I HOPE PEOPLE DO FEEL COMFORTABLE USING THEM AS MUCH AS THEY FEEL COMFORTABLE SAYING, YOU KNOW WHAT? I KNOW THE CDC SAID WHAT THEY SAID BUT I'M GOING TO WEAR A MASK FOR A LITTLE BIT AND THAT'S OKAY TOO.

Nam says DR. MILLER AND TIM, I SAW BOTH OF YOU NODDING. DR. MILLER, WHAT DO YOU MAKE OF THAT DECISION?

Kate says I THINK THERE'S A LOT OF RISK IN IT FROM THE PERCEPTION OF RELAXING TOO QUICKLY, FEELING LIKE WE'RE IN THE CLEAR BEFORE WE ARE, RIGHT? IT'S TRUE, THERE'S NOT GOING TO BE FIREWORKS TO TELL US THIS IS OVER. I AM FULLY VACCINATED. I'M WELL PAST MY SECOND DOSE. I AM STILL WEARING A MASK EVERYWHERE WHERE I AM IN THE SAME ROOM AS SOMEONE ELSE, BOTH BECAUSE I WANT TO CONTINUE TO PROTECT MYSELF. I NEED TO STAY HEALTHY. I MADE IT THIS FAR. I DON'T WANT TO GET COVID NOW. BUT ALSO BECAUSE THERE ARE NOT ENOUGH OF US FULLY VACCINATED YET TO BE FULLY SAFE YET. WE'RE LONG AWAY FROM BEING FULLY VACCINATED. [INAUDIBLE] SO IF WE ALL STAY THE COURSE AS TIM SAID WE CAN GET TO THE END OF THIS MUCH FASTER, MUCH EASIER...

[INAUDIBLE]

Nam says AND TIM?

Tim says ABSOLUTELY, I AGREE WITH MY COLLEAGUES. REMEMBER THAT THE PUBLIC IS STILL POSSIBLY THINKING THESE VACCINES ARE, AS WE BECAME FAMILIAR WITH POLIO AND MEASLES AND MUMPS, WHICH IS ESSENTIALLY IN FOR A LIFETIME PROTECTION. THINK RATHER LIKE THE INFLUENZA VACCINE, WHICH MAYBE LAST A YEAR, OR IF YOU WORK WITH ANIMALS, THE RABIES VACCINE WHICH YOU NEEDN'T TAKE EVERY YEAR OR TWO OR TETANUS EVERY 20 YEARS. EVERY SURGE HAS FOLLOWED A TOO RAPID, TOO HASTY, TOO CLUMSY REMOVAL FROM BEFORE. WE'VE SEEN IT IN MELBOURNE, IN INDIA, IN BRITAIN, WE'VE EVEN SEEN IT RECENTLY IN SINGAPORE. THEY'VE DONE VERY WELL UP TO NOW. SO WE'VE GOT A WHOLE DISCOURSE. I THINK THE IDEA IN THE STATES IS PERHAPS A LITTLE TOO HASTY. I THINK THEY DON'T THINK THEY'LL GET A FOURTH WAVE BUT IT'S NOT BEYOND THE REALM OF POSSIBILITY.

Nam says CHILDREN UNDER A CERTAIN AGE CAN'T EVEN GET VACCINATED YET. THERE'S A LOT OF ENVY ON THIS SIDE OF THE BORDER ABOUT WHAT'S HAPPENING IN THE STATES. WHEN YOU LOOK BACK ON THE LAST YEAR, OR EVEN THE LAST THREE MONTHS, WHAT WOULD YOU CHANGE IF YOU COULD? MARIA, I'LL START WITH YOU.

Maria says WHAT WOULD I CHANGE IF I COULD? I THINK THE THING THAT HAS BEEN TRUE THROUGHOUT THIS ENTIRE PANDEMIC FOR ME IS THAT I WANT PEOPLE TO SEE THE IMPORTANCE OF INVESTING IN HEALTH CARE INFRASTRUCTURE. I THINK, YOU KNOW, JUST AS WE SAID EARLIER, YOU KNOW, THERE'S A REPORT. WE HAVE GUIDANCE DOCUMENTS FOR CANADA IT WAS POST SARS, FOR THE UNITED STATES IT WAS POST N 1 H 1. WE SAID THIS COULD HAVE BEEN REALLY BAD. IT WAS NOT GREAT BUT IT COULD HAVE BEEN A LOT WORSE. HERE ARE THESE STRUCTURES WE CAN IMPLEMENT TO PREVENT THIS FROM HAPPENING AGAIN AND WE DIDN'T FOLLOW THOSE STRUCTURES. I HOPE EVERYONE HAS PUBLIC HEALTH TERMS IN THEIR VERNACULAR, THAT THEY UNDERSTAND THE IMPORTANCE OF THESE MECHANISMS THAT WE REALLY MAKE A DEDICATION TO INVESTING IN THIS INFRASTRUCTURE.

Nam says DR. MILLER?

Kate says I THINK I'D SAY TWO THINGS. ONE IS COMMUNICATION [INAUDIBLE]

[INAUDIBLE]

[AUDIO DIFFICULTIES]

Nam says TIM?

Tim says OKAY. I WOULD JUST POINT OUT WE'VE SEEN THREE CORONAVIRUS EVENTS IN THE WORLD IN THE LAST 20 YEARS. SARS I, MERS, AND SARS 2. THERE WILL BE OTHERS. I HOPE WE LEARN FROM THIS ONE, ESPECIALLY BEING PREPARED. WE'RE ABOUT 3.7 percent FULLY VACCINATED IN THIS COUNTRY, WAY DOWN THE LIST, ABOUT 40TH POSITION IN THE WORLD. THE U.S. IS ABOUT 40 percent FULLY VACCINATED. TEN TIMES BETTER. WE'VE GOT TO BE BETTER PREPARED.

The caption changes to "Producer: Meredith Martin, @meredithmartin."

Nam says TIM, MARIA, AND DR. MILLER, THANK YOU SO MUCH FOR YOUR TIME. I CAN SAY YOU'RE EXCELLENT COMMUNICATORS AND YOUR MESSAGING CAME THROUGH, WHICH WE REALLY APPRECIATE. THANK YOU SO MUCH FOR YOUR INSIGHTS.

Maria says THANKS VERY MUCH.

Watch: Can Vaccines Get Us Back to Normal?