Transcript: Racing to Vaccinate Ontario | Jun 18, 2021

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

A caption on screen reads "Racing to vaccinate Ontario. Nam Kiwanuka, @namshine, @theagenda."

Nam says ONTARIO'S VACCINE ROLL-OUT MAY HAVE GOTTEN OFF TO A SLOW AND ROCKY START, BUT DESPITE ONGOING ISSUES WITH BOOKING VACCINE APPOINTMENTS, MORE THAN 12 MILLION DOSES HAVE NOW BEEN ADMINISTERED PROVINCE-WIDE. AND, INCREASINGLY, THAT INCLUDES PEOPLE WITH TWO DOSES. WITH US NOW ON WHAT IT ALL MEANS, ESPECIALLY FOR THE SUMMER AHEAD: IN MISSISSAUGA, ONTARIO: DR. ZAIN CHAGLA, ASSOCIATE PROFESSOR IN THE DEPARTMENT OF MEDICINE AT MCMASTER UNIVERSITY AND AN INFECTIOUS DISEASE SPECIALIST AT ST. JOSEPH HEALTHCARE HAMILTON...

Zain is in his late thirties, clean-shaven, with short black hair. He's wearing a gray suit and a white shirt.

Nam continues AND IN THE PROVINCIAL CAPITAL: ASHLEIGH TUITE, INFECTIOUS DISEASE EPIDEMIOLOGIST AT U OF T'S DALLA LANA SCHOOL OF PUBLIC HEALTH...

Ashleigh is in her thirties, with long curly black hair. She's wearing a gray shirt.

Nam continues AND 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 beige shirt.

Nam continues HI, WELCOME TO YOU ALL.

Maria says THANK YOU.

Zain and Ashleigh say HI.

Nam says THIS HAS BEEN... THERE'S A LOT OF HOPE OUT THERE RIGHT NOW. YOU KNOW, THE SUMMER IS UPON US. THE WEATHER IS GREAT. PEOPLE ARE GETTING DOUBLE VACCINATED. AND DR. CHAGLA, I WANTED TO START WITH YOU, BECAUSE YOU'RE IN MY FORMER HOMETOWN OF MISSISSAUGA, THE DELTA VARIANT HAS SLOWED THE REOPENING PLAN TO THE U.K. THEY WERE ACTUALLY SUPPOSED TO OPEN THIS WEEKEND, AND THEY ARE NOW GOING TO BE REOPENING UNTIL I BELIEVE JULY 19TH, AND THERESA TAM HAS WARNED US TO BE CAUTIOUS WHEN IT COMES TO THE REOPENING PLANS THAT WE HAVE, NOT JUST FOR ONTARIO BUT FOR THE WHOLE OF THE COUNTRY. I DON'T SEEM TO BE GETTING THAT SENSE OF URGENCY. AS I MENTIONED, SUMMER TIME. PEOPLE ARE ON THE PATIOS. THE WEATHER IS NICE. HOW WORRIED SHOULD WE BE ABOUT THE DELTA VARIANT?

The caption changes to "Zain Chagla. McMaster University."
Then, it changes again to "Curbing the Delta variant."

Zain says YEAH, I MEAN, YOU KNOW, I THINK OBVIOUSLY THIS THROWS ANOTHER WRENCH INTO EVERYTHING IN TERMS OF US KNOWING WHAT COVID-19 IS GOING TO LOOK LIKE LONG TERM AND THE EVOLUTION OF HOW THIS SPREADS. BUT, YOU KNOW, THIS IS A VERY DIFFERENT POSITION THAN WHEN THE ALPHA VARIANT WAS CIRCULATING. WE HAVE VACCINES. NUMBERS ARE MUCH BETTER. AND, YOU KNOW, I THINK THERE IS A LOT MORE HOPE IN THAT CONTEXT. CERTAINLY I THINK WE DO NEED TO MASS VACCINATE OUR POPULATION AGGRESSIVELY AND THERE'S BEEN AN INCREDIBLE AMOUNT OF EFFORT GOING INTO GETTING SECOND DOSES IN INDIVIDUALS, KNOWING THAT THE EFFICACY IS MUCH HIGHER FOR A SECOND DOSE COMPARED TO A FIRST DOSE. THERE IS CERTAINLY A NEED TO BE CAREFUL WITH REOPENING AND MONITORING PARTICULARLY HOT SPOTS FOR DELTA VARIANT AND MAKING SURE VACCINATIONS AND TESTING ARE APPROPRIATE THERE. BUT, AGAIN, THE U.K. GIVES US A WINDOW. THEY'RE RELATIVELY OPEN STILL. WHAT WAS GOING TO HAPPEN NEXT WEEK WAS THERE SO-CALLED FREEDOM DAY WHEN THINGS GO BACK TO 2019 LEVELS. YOU KNOW, THEY'VE BEEN ABLE TO SHOW US THAT THE DELTA VARIANT ON THE BACK OF A PARTIALLY VACCINATED POPULATION, ON THE BACK OF, YOU KNOW, MORE CONTROLS COMING OUT OF SOCIETY, THAT THERE MAY BE TRANSMISSION AND THAT MAY TRANSLATE INTO HOSPITALIZATIONS AND HEALTH CARE UTILIZATION. FOR US WE'RE STARTING TO ESCALATE BACK INTO THAT, YEAH, IT MAKES US PAUSE, GETTING READY FOR EACH LEVEL AND MONITORING EACH LEVEL GOING FORWARD.

The caption changes to "Zain Chagla. Saint Joseph's Healthcare Hamilton."

Zain continues I THINK THE LAST BIT MISSING IN ALL OF THIS IS THERE IS A DISPROPORTIONATE AMOUNT OF THE DELTA VARIANT THAT ARE AFFECTING THOSE WHO ARE NOT VACCINATED. AND SOME POPULATIONS WE OBVIOUSLY CAN'T VACCINATE, CHILDREN UNDER THE AGE OF 12. BUT EVEN IN THOSE POPULATIONS THAT ARE NOT VACCINATED, THEY ARE SEEING THE LARGEST BURDEN OF THE DELTA VARIANT AND IT IS GOING TO HAPPEN MERE IN CANADA AND ONTARIO AND PART OF OUR STRATEGY FOR THE NEXT FEW MONTHS IS REALLY REACHING THOSE HARD-TO-REACH POPULATIONS AS THEY'RE GOING TO BE THE ONES REPRESENTED IN HEALTH CARE.

Nam says MARIA, DR. CHAGLA MENTIONED CHILDREN. WE ARE GOING TO BE TALKING ABOUT THEM IN A FEW MOMENTS. BUT HE ALSO MENTIONED HOT SPOTS. SO THIS PAST MONDAY, THE VACCINE ELIGIBILITY WAS MOVED UP FOR PEOPLE WHO HAD HAD THE ASTRAZENECA VACCINE, AND THERE SEEMS TO BE A LOT OF ACTIVISM ON THE GROUND. A LOT OF DOCTORS SPEAKING UP ABOUT THE NEED FOR, AS DR. CHAGLA SAID, FOR PEOPLE TO GET TWO DOSES. I WAS LUCKY ENOUGH TO LOG ON BY 8:00, AND SOME PEOPLE WEREN'T SO LUCKY. MY HUSBAND LOGGED ON MAYBE AN HOUR LATER, AND WE LIVE IN SCARBOROUGH, WHICH IS A HOT SPOT, BUT THE SUGGESTION WAS FOR HIM TO TRAVEL TO ORILLIA, AND I ALSO SAW ON SOCIAL MEDIA MISSISSAUGA, THERE WASN'T ANY PLACE IN MISSISSAUGA WHERE PEOPLE COULD GO WITHIN THAT CITY TO GET THE VACCINE. SO OBVIOUSLY THERE ARE SOME PROBLEMS STILL WITH BOOKING VACCINES. SHOULD PEOPLE JUST TAKE THE FIRST APPOINTMENT THEY CAN GO NO MATTER WHERE IT IS, IF IT'S IN A HOT SPOT OR NOT?

The caption changes to "Maria Sundaram. ICES."

Maria says THAT'S A REALLY GREAT QUESTION. UNFORTUNATELY, THE ANSWER IS A LITTLE LONGER BUT I'LL TRY TO BE CONCISE. OVERALL, THE ANSWER IS YES. IF YOU CAN GET A SECOND DOSE, YOU SHOULD GET A SECOND DOSE. YOU MAY HAVE SEEN THAT NACI JUST RELEASED GUIDANCE YESTERDAY SUGGESTING THAT FOR THOSE WHO GOT THE FIRST DOSE AS AN ASTRAZENECA VACCINE, THEY IDEALLY WOULD GET AN MRNA VACCINE FOR THEIR SECOND DOSE. THAT MAY NOT BE POSSIBLE OR ACCESSIBLE TO EVERYONE. IT'S CHALLENGING TO TELL PEOPLE, MAY, WE PREFER YOU GET AN MRNA VACCINE, BECAUSE IT FEELS LIKE IF THE SECOND DOSE IS ASTRAZENECA THEY'RE NOT GETTING THE BEST RESULT AND THAT'S A PROBLEM. YOU ALLUDED TO THE ACCESSIBILITY AND HOT SPOTS. IT GOES BACK TO VACCINE EQUITY THAT WE HAD FOR THE FIRST DOSE, EVEN GOING BACK TO FEBRUARY. NOW WE'RE SEEING DATA FROM I.C.E.S., WE'RE SEEING THE SAME PROBLEM FOR DOSE 2 AS DOSE 1. THIS IS NOT SURPRISING. PEOPLE ELIGIBLE GOT THEIR DOSE A WHILE AGO. THOSE WERE THE PEOPLE THAT KIND OF HAD ACCESS IN THE BEGINNING. BUT WE STILL HAVE THESE ROLLOUT LOGISTICAL CHALLENGES WITH GETTING VACCINE TO THE NEIGHBOURHOODS THAT REALLY NEED IT THE MOST. SO I THINK IN MANY WAYS WE'RE JUST KINDS OF LIKE WITH EACH NEW PAGE THAT WE TURN IN THIS PANDEMIC, THERE'S A NEW CHALLENGE, BUT IT'S A CHALLENGE ALSO HOPEFULLY NOT UNFAMILIAR TO US AND WE REALLY NEED TO START TAKING THOSE CHALLENGES, ESPECIALLY THE ONES OF VACCINE EQUITY, VERY SERIOUSLY.

Nam says YOU KNOW, LIKE DR. CHAGLA SAID, WE CAN LOOK TO THE U.K. TO LEARN SOME OF THESE LESSONS, AND WE KNOW WHAT THE ROLLOUT FOR THE FIRST DOSE WAS LIKE. SO YOU WOULD THINK THAT MAYBE FOR THIS SECOND DOSE THINGS WOULD BE CHANGING. AGAIN, I WANT TO ASK YOU, MAYBE... I WANT TO REFRAME MY QUESTION BECAUSE WE'VE HAD THIS MESSAGE FROM THE GOVERNMENT AND FROM HEALTH OFFICIALS SAYING, DON'T TRAVEL TO OTHER REGIONS. YOU KNOW, WHEN WE DID HAVE THE STAY-AT-HOME ORDER. AND NOW WE'RE BEING OFFERED VACCINES THAT, YOU MIGHT BE IN A HOT SPOT, BUT THEN YOU'RE GETTING A VACCINE BUT THAT'S NOT IN A HOT SPOT. SO SHOULD YOU STILL REALLY BE DOING THAT? SHOULD WE BE DOING THAT?

Maria says THAT'S A TOUGH QUESTION TO ANSWER. I WOULD SAY MY GUIDANCE AND ADVICE FOR INDIVIDUAL PEOPLE IS, IF YOU CAN GET A SECOND DOSE, YOU SHOULD. I TOTALLY AGREE WITH DR. CHAGLA'S, YOU KNOW, THOUGHT THAT WE REALLY NEED TO GET SECOND DOSES INTO PEOPLE, ESPECIALLY WITH EXPLODING VARIANTS OF CONCERN. WE KNOW THAT THE VACCINE EFFECTIVENESS POST SECOND DOSE, ESPECIALLY FOR THOSE VARIANTS, IS MUCH BETTER THAN FOR JUST THE FIRST DOSE ALONE. AND I REALLY HOPE THAT THAT ALSO HELPS PEOPLE FEEL A LITTLE BIT MORE COMFORTABLE AS THINGS DO START TO OPEN UP, SORT OF SIMULTANEOUSLY. BUT, YOU KNOW, ALSO IT'S REALLY CHALLENGING TO ISSUE GUIDANCE SAYING, HEY, WE PREFER YOU GET AN MRNA VACCINE AS YOUR SECOND DOSE. IF YOU GOT ASTRAZENECA AS YOUR FIRST DOSE. AND THEN NOT MAKE THAT OPTION AVAILABLE TO PEOPLE. THAT REALLY DOES NEED TO HAPPEN.

Nam says ASHLEIGH, I WANTED TO FOLLOW UP WITH YOU. MARIA MENTIONED NACI CHANGED THE GUIDANCE AND DID SAY IF YOU DID GET AN ASTRAZENECA VACCINE, IT'S PREFERRED TO GET THE SECOND AN MRNA. WHY DID THEY CHANGE THEIR SECOND POSITION?

The caption changes to "Ashleigh Tuite. University of Toronto."

Ashleigh says I THINK THEY BASED IT ON A COUPLE OF THINGS. THE MAIN IS SUPPLY. RIGHT NOW WE HAVE ENOUGH OF THE MRNA VACCINES THAT WE CAN OFFER THE MRNA VACCINES TO ANYBODY WHO WANTS IT. WE HAVE THE DATA, NOT ALL THE DATA THAT WE WOULD NECESSARILY WANT, IN TERMS OF WE DON'T HAVE POPULATION STUDIES WHERE WE'VE GONE OUT AND DONE THIS AND SORT OF LOOKED AT THE EFFECTIVENESS OF A MIXED DOSE REGIMEN VERSUS TWO ASTRAZENECA DOSES. BUT WE HAVE SOME STUDIES LOOKING AT ANTIBODIES AND THE ANTIBODY RESPONSE IN PEOPLE WHO HAVE RECEIVED FIRST DOSE ASTRAZENECA, SECOND DOSE MRNA, AND THE DATA WE HAVE SUGGESTS THAT THE RESPONSE LOOKS BETTER IN PEOPLE WHO HAVE THAT MIXED DOSE. SO, YOU KNOW, THE COMBINATION OF, YOU KNOW, THE MIXED ASTRAZENECA FIRST, MRNA SECOND, DOESN'T LOOK WORSE. WE HAVE ABUNDANT MRNA VACCINES RIGHT NOW. AND WE KNOW THERE IS THAT RISK OF IT WITH THE ASTRAZENECA VACCINE THAT WE DON'T HAVE WITH MRNA. SO BASED ON THAT CONSTELLATION OF SORT OF SUPPLY ISSUES AS WELL AS EMERGING DATA, THAT HAS REALLY I THINK PUSHED US TOWARD RECOMMENDING THAT PEOPLE DO GET A SECOND DOSE OF MRNA VACCINE, IF IT'S POSSIBLE. BUT AGAIN, YOU KNOW, I THINK IT'S REALLY IMPORTANT TO REMEMBER, AS WE HAVE THIS DISCUSSION AND AS WE'VE HAD THESE DISCUSSIONS OVER THE PAST SEVERAL MONTHS, AND THAT THE ADVICE THAT WAS GIVEN TWO MONTHS AGO OR A MONTH AGO WASN'T WRONG ADVICE AT THE TIME. IT'S JUST THAT OUR SITUATION IS CHANGING. YOU KNOW, WE'RE SORT OF PROVIDING VACCINE GUIDANCE DURING THE COURSE OF A PANDEMIC, AND SO WE HAVE EMERGING DATA, WE HAVE DIFFERENT CHANGES IN TERMS OF SUPPLY. WE HAVE, YOU KNOW, TWO MONTHS AGO, WE WERE IN THE MIDST OF A VERY BAD THIRD WAVE AND WE REALLY JUST WANTED EVERYBODY TO GET VACCINATED AS QUICKLY AS POSSIBLE. SO AS MUCH AS THIS CAN FEEL FRUSTRATING AND OVERWHELMING TO HAVE THIS CHANGING DATA AND PEOPLE MAY BE FEELING LIKE THEY DIDN'T GET THE BEST VACCINE, THE REALITY IS THAT ALL OF THESE VACCINES ARE HIGHLY EFFECTIVE FOR PREVENTING SEVERE OUTCOMES, AND, YOU KNOW, WE'RE MAKING THESE CHANGES BASED ON THE CHANGING REALITIES ON THE GROUND.

Nam says I WAS GOING TO ASK YOU THAT BECAUSE THERE ARE PEOPLE WHO HAVE HAD TWO DOSES OF ASTRAZENECA, AND THINKING THAT, YES, WE WORKED WITH THE SCIENCE THAT WE HAD AT THE TIME. BUT IF THAT'S THE VACCINE THAT YOU HAD, MAYBE YOU ARE FEELING A LITTLE BIT MORE STRESSED. MAYBE YOU DON'T FEEL AS SAFE AS OTHER PEOPLE WHO HAVE HAD THE MRNA VACCINES. WHAT WOULD YOU SAY TO THOSE PEOPLE?

The caption changes to "Ashleigh Tuite, @AshTuite."

Ashleigh says I WOULD SAY THAT, YOU KNOW, BASED ON THE DATA THAT WE HAVE RIGHT NOW, TWO DOSES OF ASTRAZENECA ARE HIGHLY EFFECTIVE FOR PREVENTING HOSPITALIZATIONS AND MORTALITY. AND THE REALITY IS THAT THAT'S WHAT REALLY MATTERS THE MOST. YOU KNOW, THERE ARE THINGS THAT SEEM TO BE LESS EFFECTIVE FOR PREVENTING ASYMPTOMATIC INFECTION, BUT IF YOU ARE INFECTED BUT DON'T GO ON TO DEVELOP THOSE SEVERE OUTCOMES, YOU SORT OF DEFANGED THE VIRUS. WHICH IS NOT TO SAY THAT HAVING ASYMPTOMATIC INFECTION IS NOTHING, IT'S IMPORTANT. BUT YOU ARE VERY WELL-PROTECTED AGAINST THE WORST OUTCOMES OF INFECTION. THE OTHER PIECE TO THIS IS, AS WE HAVE MORE DATA, AS WE SORT OF STUDY THE LONGER-TERM PROTECTION THAT PEOPLE HAVE WITH THESE VACCINES, WE MAY HAVE DATA SUGGESTING THAT PEOPLE WHO RECEIVED TWO DOSES OF ASTRAZENECA OR EVEN PEOPLE WHO DO RECEIVE TWO DOSES OF MRNA MAY NEED A BOOSTER. THAT GUIDANCE WILL BE PROVIDED OVER TIME. RIGHT NOW PEOPLE ARE PROTECTED AND THEY SHOULD FEEL GOOD ABOUT HAVING TWO DOSES IN THEIR ARM.

Nam says WHILE THE W.H.O. HAS APPROVED THE ASTRAZENECA VACCINE, THE FDA IN THE UNITED STATES HASN'T. I KNOW YOU'VE HEARD THIS STORY THIS PAST WEEK. PRODUCERS OF AN UPCOMING BROADWAY SHOW SAID THAT IF YOU HAVE RECEIVED THE ASTRAZENECA VACCINE, YOU'RE NOT WELCOMED. OR IF YOU RECEIVED AN FDA APPROVED VACCINE LIKE PFIZER OR MODERNA OR JOHNSON and JOHNSON. WHAT DO YOU SAY TO PEOPLE WHO RECEIVED THE ASTRAZENECA VACCINE?

Zain says IF YOU CAN TELL GENERATION X THAT THEIR CHOICE TO TAKE ASTRAZENECA WAS ANY WORSE, THIS DIDN'T HELP IN THAT SENSE.

Nam says THAT'S ME.

Zain says EXACTLY. ONE THING ON TOP OF ANOTHER. AGAIN, IT'S INTERESTING ABOUT THIS U.S. SITUATION BECAUSE THE ONLY REASON ASTRAZENECA WASN'T APPROVED WASN'T NECESSARILY BECAUSE OF AN EFFICACY ISSUE, IT WAS SIMPLY BECAUSE AT THE TIME THEY HAD APPROVED MODERNA, PFIZER, AND THE JANSEN VACCINE AND THE SIGNAL TOWARDS BLOOD CLOTTING WITH THE ASTRAZENECA AND EVENTUALLY WITH JANSEN IT SHOWED UP. THERE WAS NO REASON FOR IT TO COME ONTO THE U.S. MARKET AND IT NEVER REALLY WAS APPROVED. IT DOES START THE BROADER DISCUSSION, THOUGH, RIGHT? I THINK WE ARE, AS MUCH AS WE THINK THAT VACCINE PASSPORTS AREN'T COMING, THERE IS GOING TO BE A NEED FOR VACCINE ASSURANCE AS PART OF ENTRY, AT LEAST INTO BORDERS, BUT EVEN MORE THAN THAT. UNFORTUNATELY, YOU KNOW, SOME OF THESE DISCUSSIONS MAY BE ARBITRARY, YOU KNOW, ONE COUNTRY MAY USE A CERTAIN VACCINE BUT NOT USE ANOTHER BASED ON WHAT THEY'VE APPROVED AND WHAT THEY HAVE ACCESS TO. REMEMBER, GLOBALLY, THESE VACCINES HAVE HAD INEQUITABLE ACCESS. SOME COUNTRIES, VERY MINIMAL ACCESS THROUGH COVAX TO HAVE A SET OF VACCINES. AND SO I DO THINK WE HAVE TO GIVE PAUSE. WE DO HAVE TO GO THROUGH A STANDARDIZATION PROCESS AND THE WORLD HEALTH ORGANIZATION IS STARTING TO STANDARDIZE VACCINES, BOTH FROM THE TYPICAL DRUG MANUFACTURERS FROM CHINA, FROM RUSSIA, FROM INDIA. YOU KNOW, I THINK THAT DOES PROMPT A BROADER DISCUSSION. WE CAN'T REALLY DISCRIMINATE FOR NOT GETTING A PREFERRED VACCINE BUT STILL DOING THEIR PART TO GET THE FIRST VACCINE AVAILABLE. WE DO HAVE TO MAKE SURE THERE'S SOME EQUITY OUT THERE AND THAT'S REALLY UP TO OUR FEDERAL AND PROVINCIAL LEADERS TO REGULATE IT.

Nam says MARIA, HEALTH MINISTER CHRISTINE ELLIOTT SAID THIS PAST WEEK THAT GUIDELINES WERE COMING OF WHAT PEOPLE CAN AND CAN'T DO NOW THAT THEY'VE BEEN VACCINATED. I'VE ALSO HEARD FROM VIEWERS, SENIORS WHO HAVE SAID THAT THEY WEREN'T ABLE TO GET A VACCINE BECAUSE THEY'RE IMMUNOCOMPROMISED, BUT THEY DON'T KNOW WHAT TO DO. YOU KNOW, HOW IMPORTANT IS THAT DISCUSSION, COMMUNICATING WHAT WE CAN AND CANNOT DO IF WE ARE VACCINATED OR NOT VACCINATED?

The caption changes to "Protocols for inoculated people."

Maria says I THINK IT'S INCREDIBLY IMPORTANT. IF ONLY BECAUSE IT'S SOMETHING THAT PEOPLE REALLY WANT TO KNOW. BUT IT'S ALSO REALLY HELPFUL TO SAY, HEY, IF YOU'RE FULLY VACCINATED, HERE ARE THE THINGS YOU CAN DO SAFELY. YOU CAN, FOR EXAMPLE, THEORETICALLY HANG OUT IN AN INDOOR ENVIRONMENT WITH ANOTHER FULLY VACCINATED PERSON. THAT'S A LOW-RISK INTERACTION. SO HOPEFULLY THAT WILL BE A COMPONENT OF THESE GUIDELINES. I DO THINK IT'S REALLY HELPFUL FOR PEOPLE TO HAVE THAT WRITTEN DOWN. I DON'T THINK IT'S FAIR FOR US TO SAY, WELL, JUST USE YOUR BEST JUDGMENT. NOT ALL OF US ARE INFECTIOUS DISEASE EPIDEMIOLOGISTS AND SOME OF US REALLY NEED TO... LIKE, WE WANT TO SEE THE GUIDANCE. THAT BEING SAID, I DON'T... WHAT I'M CONCERNED ABOUT IS USING FULL VACCINATION AS AN INCENTIVE FOR FREEDOM AT THIS POINT BECAUSE WE'VE SEEN SO MANY CHALLENGES, AGAIN, WITH VACCINE EQUITY. ON A LOCAL LEVEL BUT ALSO ON A GLOBAL LEVEL, THAT IF WE SAY, HEY, IF YOU'RE FULLY VACCINATED, HERE'S ALL THE THINGS YOU CAN DO. THAT'S GOING TO FEEL REALLY TERRIBLE TO PEOPLE WHO HAVEN'T HAD THE ACCESS TO THAT SECOND DOSE YET.

Nam says AND OF COURSE YOU MENTIONED CHILDREN BEFORE, ASHLEIGH. I WANTED TO FOLLOW UP WITH THAT. BECAUSE WE'VE BEEN TALKING ABOUT VACCINATIONS PROTECTING US AGAINST THE DELTA VARIANT. BUT THAT DOESN'T MEAN YOU STILL CAN'T GET VACCINATED. BUT CHILDREN UNDER 12 CAN'T BE VACCINATED YET. HOW WORRIED SHOULD WE BE ABOUT GETTING THIS UNDER CONTROL IF NONE OF THE VACCINES ARE APPROVED FOR CHILDREN UNDER THE AGE OF 12?

Ashleigh says YEAH, NO, IT'S A REALLY IMPORTANT QUESTION, AND IT'S SOMETHING THAT I THINK, YOU KNOW, BECOMES MORE AND MORE IMPORTANT AS WE HAVE MORE OF THE POPULATION VACCINATED AND AS WE START HAVING THESE CONVERSATIONS ABOUT OPENING UP AND HAVING FREEDOM BECAUSE, YOU KNOW, IT'S NOT JUST CHILDREN, IT'S ALSO PEOPLE WHO, YOU KNOW, HAVEN'T BEEN VACCINATED FOR VARIOUS OTHER REASONS. AND, YOU KNOW, WHEN WE START TALKING ABOUT WHAT PEOPLE CAN DO WHEN THEY'RE FULLY VACCINATED, IT STARTS SHIFTING RESPONSIBILITY TOWARDS THE INDIVIDUAL AND, YOU KNOW, THERE'S THIS SENSE, YOU'VE BEEN VACCINATED, YOU GET THIS REWARD. WHICH ON THE ONE HAND IS APPROPRIATE BECAUSE WE DO WANT PEOPLE TO GET VACCINATED AND WE DO WANT THEM TO UNDERSTAND THAT VACCINE DOES PROVIDE THEM WITH THOSE FREEDOMS. BUT WE ALSO HAVE TO UNDERSTAND THAT WE'RE TALKING ABOUT A COMMUNICABLE DISEASE AND WE DO HAVE POCKETS OF OUR POPULATION WHO ARE VULNERABLE AND WHO, YOU KNOW, CAN'T SHIFT THAT RESPONSIBILITY ONTO THEM. AND KIDS ARE A PERFECT EXAMPLE OF THAT, YOU KNOW, WHERE COME THE NEXT COUPLE MONTHS, AS WE START OPENING UP AND AS I THINK, YOU KNOW, WE START TALKING ABOUT THE RETURN TO SCHOOL IN THE FALL, WE HAVE A HIGHLY VULNERABLE GROUP OF PEOPLE WHO ARE GOING TO BE SPENDING TIME INDOORS IN CLASSROOMS WITHOUT THE BENEFIT AMONGST THE YOUNGER KIDS, OF BEING VACCINATED. AND SO IF WE, YOU KNOW, DON'T GET COVID NUMBERS DOWN TO REALLY LOW LEVELS VIA VACCINATION AND VIA, YOU KNOW, I THINK THIS CAUTIOUS REOPENING, WHICH IS REALLY IMPORTANT, THEN WE HAVE TO BE AWARE OF THE FACT THAT THERE'S THE POTENTIAL COME THE FALL THAT WE HAVE REALLY LARGE OUTBREAKS HAPPENING IN KIDS AND IN OTHER UNVACCINATED POPULATION GROUPS. YOU KNOW, I THINK, YOU KNOW, THE CONVERSATION AROUND SCHOOLS AND KIDS IS HIGHLY POLARIZED. BUT THE REALITY IS THAT THIS IS A NOVEL INFECTIOUS DISEASE AND THERE'S NO IMMUNITY IN OUR POPULATION, WHICH IS WHY WE HAD, YOU KNOW, A PANDEMIC. BUT, YOU KNOW, IF WE ALLOW THIS TO SPREAD SORT OF WITHOUT PUBLIC HEALTH MEASURES IN PLACE IN KIDS, WE CAN EXPECT TO SEE LARGE NUMBERS OF PEOPLE GETTING INFECTED AND SOME OF THOSE KIDS ARE GOING TO HAVE BAD OUTCOMES. SO I THINK WE NEED TO BE AWARE OF THE FACT THAT JUST BECAUSE WE REACH THESE VACCINATION MILESTONES, THIS PANDEMIC HASN'T GONE AWAY. IT'S NOT GOING TO GO AWAY FOR A WHILE. DO WE REALLY NEED TO BE FOCUSED NOT ONLY ON THOSE VACCINATION TARGETS BUT ALSO ON, YOU KNOW, WHAT'S HAPPENING WITH TRANSMISSION IN OUR COMMUNITY AND IN THESE POCKETS OF VULNERABLE PEOPLE.

Nam says MARIA, I SAW YOU NODDING YOUR HEAD.

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

Maria says OH, YEAH, ABSOLUTELY. AND I THINK THE BIG THING THAT I AGREE WITH YOU, ASHLEIGH, ON IS THAT THIS DISCUSSION HAS REALLY BEEN HIGHLY POLARIZED, WHICH I THINK IS A LITTLE UNFORTUNATE BECAUSE, OF COURSE, AS YOU MENTIONED, THE MOST IMPORTANT THING IS, WE NEED TO MAKE SURE THAT ALL OF US ARE PROTECTED, AND IF WE HAVE THIS LARGE GROUP OF PEOPLE IN OUR POPULATION... CHILDREN... WHO CAN'T BE PROTECTED BY A VACCINE, WE CAN VERY MUCH EXPECT THAT PATHOGEN WILL MOVE THROUGH THAT GROUP THAT'S NOT PROTECTED AND WE KNOW THAT CHILDREN CAN GET SEVERE DISEASE, AND WE ALSO KNOW THAT THEY ARE WHAT'S CALLED HIGH DEGREE NODES IN CONTACT NETWORKS. THEY TEND TO HAVE A LOT OF PEOPLE THAT THEY INTERACT WITH. AND THAT ALSO MEANS A LOT FOR US IN TERMS OF INFECTIOUS DISEASE PROTECTION. SO, YEAH, I AGREE WITH EVERYTHING THAT YOU SAID.

Nam says IT'S BEEN INTERESTING TO SEE THIS DISCUSSION AROUND SCHOOLS AND PATIOS. I THINK WHEN THE GOVERNMENT DECIDED TO OPEN PATIOS, ON SOCIAL MEDIA IT WAS KIND OF LIKE, ARGH! WE'RE HAVING THESE KIND OF CONVERSATIONS I DON'T THINK WE WOULD IMAGINE TWO YEARS AGO DECIDING WHO DO YOU SEE IN YOUR SOCIAL CIRCLE? DO YOU HAVE ONE DOSE, TWO DOSE, NO DOSE? HOW DO YOU ASK THOSE QUESTIONS? DR. CHAGLA, WE LOOK AT THE U.S. AND, YOU KNOW, THE CDC RECOMMENDED THAT THEY DON'T NEED TO WEAR A MASK ANYMORE. IS NOT WEARING A MASK POSSIBLE IN OUR NEAR FUTURE HERE?

The caption changes to "Zain Chagla, @zchagla."

Zain says YEAH, I MEAN, YOU KNOW, IT'S INTERESTING. I THINK, YOU KNOW, WORKING IN A HEALTH CARE ENVIRONMENT, I DON'T KNOW IF WE'RE GOING TO GET RID OF MASKS VERY QUICKLY. YOU KNOW, FOR WHAT THEY'VE DONE FOR PREVENTING TRANSMISSION OF NOT JUST COVID-19 BUT OTHER RESPIRATORY PATHOGENS, AS MUCH AS AS WE WITH DON'T LIKE THEM IN CERTAIN CONTEXTS, THEY MAY HAVE A UNIVERSAL GOOD THERE AND IT'S ONE OF THOSE THINGS THAT MAY BE ENSHRINED. IS THERE A PATHWAY OUT OF MASKS? YEAH, I THINK SO AT SOME POINT IN TIME. BUT AS WAS MENTIONED, CHILDREN IN SCHOOLS, PARTICULARLY NEXT YEAR, THEY'RE A VULNERABLE POPULATION. THEY COULD VERY WELL STILL SPREAD THROUGH AND MASKING MAY NEED TO BE A PART OF THAT REALLY AS A MITIGATION TECHNIQUE AS WELL AS VENTILATION AND ADEQUATE CLASS SIZES TO SUPPORT CHILDREN BEING IN SCHOOLS AND NOT LEADING TO OUTBREAKS AND DISRUPTIVE LEARNING. FROM A SOCIETAL STANDPOINT, I DO THINK WE NEED TO MAINTAIN MASKS PARTICULARLY BECAUSE THERE ARE SUCH RISK GRADIENTS AMONG PEOPLE, AT LEAST UNTIL WE HAVE A SIGNIFICANT THRESHOLD OF ADULTS AND ONES THAT COULD BE OVERREPRESENTED IN HEALTH CARE REALLY IMMUNIZED SUCH THAT AT LEAST WE DON'T SEE THE MASKS COMING OFF AS A LARGE TRANSMISSION EVENT. AND I THINK WE LOOK AT THE UNITED STATES, YOU KNOW, MANY OF US IN ENVY I THINK WATCHING THE BASKETBALL AND HOCKEY PLAYOFFS NOW SEEING FULL STADIUMS AND SAYING, WHY CAN'T WE GET TO THAT? WE'RE BARELY EVEN ALLOWED TO BE INDOORS WITH PEOPLE. AND, AGAIN, THAT IS ALSO THE COST OF A LARGE VACCINE CAMPAIGN BUT ALSO A LARGE NUMBER OF PEOPLE THAT DERIVED NATURAL IMMUNITY THE HARD WAY WHILE GETTING INFECTED. THE COMBINATION OF THE TWO PUTS THEM SLIGHTLY AHEAD OF US IN TERMS OF VACCINE EFFICACY AND POPULATION IMMUNITY, AND SO, YOU KNOW, WE ARE STILL A WAYS WAY BACK FROM THEM ALTHOUGH HEADING IN THAT DIRECTION CAREFULLY WITHOUT HAVING THE DAMAGE OF HOW MUCH TRANSMISSION THEY HAD DURING THEIR FIRST THREE WAVES.

Nam says ASHLEIGH, LAST WEEKEND WE SAW A LOT OF PATIOS BRIMMING BECAUSE THAT IS SOMETHING THAT WE CAN NOW DO. IS THERE A RISK THAT PEOPLE WILL MAYBE FORGET ABOUT THE PRECAUTIONS THAT WE HAD AND THIS IS HAPPENING TOO SOON?

The caption changes to "Summer of (some)freedom?"

Ashleigh says I MEAN, THERE'S ALWAYS A RISK, RIGHT? I DON'T... IT'S NOT SOMETHING THAT REALLY WORRIES ME, TO BE PERFECTLY HONEST. I THINK, YOU KNOW, THE FACT THAT WE'RE DOING THIS SLOWLY, YOU KNOW, WE'RE DOING THINGS PRIMARILY OUTDOORS. YOU KNOW, THE INDOOR SHOPPING STUFF IS TO ME RELATIVELY LOW RISK. PEOPLE ARE WEARING MASKS STILL. I THINK, YOU KNOW, IN GENERAL THE GUIDANCE AROUND TAKING THINGS OUTDOORS AND REALLY, YOU KNOW, RECOGNIZING THAT OUTDOORS IS LOWER RISK HAS GOTTEN THROUGH, AND, YOU KNOW, OF COURSE THERE ARE PEOPLE WHO ARE GOING TO PUSH THINGS A LITTLE BIT FARTHER AND THERE ARE GOING TO BE PEOPLE WHO, YOU KNOW, START INVITING PEOPLE OVER TO THEIR HOMES AND WHATNOT. BUT I THINK SORT OF ON THE POPULATION LEVEL, I DON'T REALLY WORRY ABOUT THAT. I THINK THAT THE PLAN THAT WE HAVE RIGHT NOW IS GOOD. I THINK THAT IT'S APPROPRIATELY CAUTIOUS. AND I HONESTLY THINK THAT AT THIS POINT, YOU KNOW, EVERYBODY WANTS THIS TO BE OVER AND WE DON'T WANT TO BE TALKING ABOUT ANOTHER PERIOD OF LOCKDOWNS OR RESTRICTIONS. AND SO I THINK IN GENERAL PEOPLE ARE, YOU KNOW, SLOWLY AND CAUTIOUSLY LISTENING. THEIR BEHAVIOURS AND SORT OF RECOGNIZING THE FACT THAT RISK IS GOING DOWN. BUT I'M NOT PARTICULARLY WORRIED THAT, YOU KNOW, INDIVIDUAL BEHAVIOURS ARE GOING TO TAKE US OFF-TRACK. I THINK, IF ANYTHING, IT'S GOING TO BE THE SORT OF LARGER PLAN THAT IF WE RUSH THINGS TOO QUICKLY.

Nam says AND, MARIA, MANY BUSINESSES ARE PREPPING THEIR EMPLOYEES FOR A RETURN TO WORK. IS THERE ANYTHING THEY NEED TO RECONSIDER... NEED TO CONSIDER BEFORE CALLING PEOPLE BACK INTO THE OFFICE?

Maria says I THINK THERE ARE A LOT OF THINGS THEY NEED TO CONSIDER. YOU KNOW, BOTH MY CO-PANELISTS KIND OF MADE REFERENCE TO THIS. THE IDEA THAT THIS IS KIND OF AN INDIVIDUAL LEVEL RESPONSIBILITY I THINK IS PERHAPS NOT REALLY AN ACCURATE DESCRIPTION OF HOW WE WANT TO CONTROL INFECTIOUS DISEASES AND PANDEMICS. WE HAVE TO THINK ABOUT THE SYSTEMIC STRUCTURAL FACTORS THAT HELP PEOPLE STAY SAFE AND ALSO HELP THEM FOLLOW THE GUIDELINES THAT WE CAN GIVE THEM. AND SO THIS IN TERMS OF WORKPLACES, THIS INCLUDES THINGS LIKE BEING FLEXIBLE FOR PEOPLE WHO STILL WANT TO WORK FROM HOME OR STILL WOULD PREFER TO WORK FROM HOME. IT INCLUDES THINGS LIKE IMPROVED VENTILATION, FLEXIBILITY FOR DESK PLACEMENT, BUT ALSO THEN I THINK THERE'S... WE'VE SEEN REALLY CONSISTENTLY THROUGHOUT THIS PANDEMIC SORT OF A CO-PANDEMIC OF MENTAL HEALTH CHALLENGES. AND I THINK THAT MANY PEOPLE WIND UP ACCESSING MENTAL HEALTH CARE THROUGH THEIR WORK, THROUGH EAP OR THROUGH OTHER RESOURCES. I THINK IT'S REALLY IMPORTANT FOR COMPANIES TO CONTINUE PROVIDING THOSE RESOURCES AND SAYING, HEY, YOU KNOW, WE'RE NOT GOING BACK EXACTLY TO HOW THINGS WERE IN 2019. WE ARE ALL DIFFERENT PEOPLE. AND WE'VE ALL GONE THROUGH SOMETHING TOGETHER. AND WE NEED TO SORT OF ACKNOWLEDGE THAT AND CONTINUE ACKNOWLEDGING THAT AS WE SORT OF MOVE BACK FROM THIS PANDEMIC AND RECOVER.

Nam says DR. CHAGLA, I'M GOING TO GIVE YOU THE LAST 30 SECONDS. SCHOOL IS COMING UP IN SEPTEMBER. WHAT SHOULD SCHOOLS AND THE GOVERNMENT BE DOING TO PREPARE FOR A SAFE RETURN TO SCHOOL IN SEPTEMBER?

The caption changes to "Prepping for a new school year."

Zain says I MEAN, NUMBER ONE, PREPARING NOW, RIGHT? I THINK WE'VE BEEN CAUGHT FLAT-FOOTED BEING, YOU KNOW, TOO DELAYED IN THIS. I MEAN, AGAIN, CLASS SIZES, IMPROVED VENTILATION, REALLY CONSIDERATION OF A MASK POLICY AT THAT POINT UNTIL COMMUNITY NUMBERS ARE STABLE, YOU KNOW, AND, YOU KNOW, TRYING TO MINIMIZE THE NUMBER OF DAYS WITH KIDS AWAY FROM SCHOOL AND HAVING A TEST STRATEGY DEVELOPED FOR KIDS. THOSE ARE GOING TO BE THE PIECES OF AN UNVACCINATED POPULATION TO KEEP THEM SAFE UNTIL WE GET THE CLINICAL TRIAL DATA.

The caption changes to "Producer: Carla Lucchetta, @carrletta."

Nam says THANK YOU SO MUCH. YOU THREE ARE EXCELLENT COMMUNICATORS. WHENEVER YOU'RE ON THE SHOW, WE GET LOTS OF EMAILS FROM PEOPLE SAYING HOW MUCH BETTER THEY FEEL ABOUT KNOWING THIS INFORMATION. THANK YOU SO MUCH FOR YOUR INSIGHTS. WE APPRECIATE IT.

Maria says THANKS SO MUCH.

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