Friday, March 12, 2021

O Canada: The Vaccination Saga

      "Peter, great news! I got my COVID shot. My wife, too. And we have our second one scheduled!"       

             Voice message left on my phone, yesterday

For a lot of seniors the COVID vaccine is a big deal. The shot represents freedom, like turning 16 and getting a driver's license.

"How are you doing. Have you started your vaccines yet?  That is the way a lot of conversations begin among people my age--71. Seniors understand that the drift of national policy--by intention last year and by impatience and carelessness now--is for seniors to protect themselves. The virus is out there; it is still spreading; young people feel immune; lots of Republican-Trump voters feel the whole thing is an overblown hoax. Therefore, for the worried and vulnerable, don't rely on your neighbors to protect you. Protect yourself. Mask up and keep your distance.

Most important, hurry up and get the vaccination.

Email correspondents around the country tell me their story. Long wait times on telephone hot lines. Internet glitches where people log in to schedule something, then get logged off. One Boston-area college classmate told of a subway ride to Fenway Park in Boston to get a shot, but his wife needed to travel to a town two hours away to get hers. A classmate in Montana said it was "extremely easy," with an effortless on-line sign-up, then an uncrowded trip to a county fairgrounds where he was whisked through. 

Another wrote from Mexico, saying there was a national registry and people were contacted using WhatsApp. Another compared the U.S. state-by-state program unfavorably to the system in the United Kingdom, where they have a National Health Service. 

Within all this chatter about vaccinations there has been a presumption that the U.S. system is a comparative mess. Our health care system is fractured, our payment system is incomprehensible, every state is different, and most Democrats believe Trump mishandled things from the start. Everybody has some problem to condemn. Democrats scoff at South Dakota, Texas, and Mississippi for doing too little. States with Democratic governors, especially New York's Andrew Cuomo and California's Gavin Newsom, are subjects of GOP condemnation. Some seniors in Oregon are complaining that the Democratic governor prioritized teachers over them.

Canada's Justin Trudeau, now bearded
For the past four years Canada stood out in the minds of Democrats as the sustained voice of political reason and good governance. After all, its Prime Minister is a cultured young liberal, Justin Trudeau, the very opposite of Trump. Isn't Canada the Promised Land?  Surely Canada did everything right. Sandford Borins says "no."

Sandford Borins is Canadian. He is a college classmate who had a long career teaching government and management at the University of Toronto. He has an up close view of the vaccine experience in the metropolis of Toronto in the Province of Ontario. For the reference of American readers, Ontario and Toronto are not exotic, unimaginably-different places buried deep in Arctic ice. Metropolitan Toronto is essentially another Great Lakes city, approximately the size of Chicago, located at about the same latitude as Boston and my home in Medford, Oregon.

His story will sound familiar to U.S. residents, who are home feeling frustrated at the effort to get a vaccination. 

Guest Post by Sandford Borins

Vaccine supply (a federal responsibility) has been slow until recently because Canada no longer has manufacturing capacity and because the government decided to buy or option lots of vaccine but was flexible about delivery dates.

Borins, at the British Museum, pre-COVID

The Onterio government has completed vaccinating all residents of seniors homes and most health care workers and is now beginning the general population, by age. A province-wide booking website (sole-sourced to Deloitte, another Ford Government no-brainer) is due to launch next Monday. Meanwhile numerous hospitals and municipalities have set up their own booking sites. I registered my 97 year old mother a little over a week ago on one of the Toronto hospital sites and she was vaccinated (Pfizer) yesterday, among the first at the hospital. Her second shot will be in late June, because the government has decided on a four-month delay between shots (to get more first shots done). My 61 year old brother is likely to be vaccinated in a pilot program to vaccinate 60-64 year olds with AstraZeneca. I've booked with the same hospital as my mother and as a 71 year old will be vaccinated in May, or maybe April if things are going well. 

The retired general who was hired to run the vaccination rollout in Ontario is telling people not to overload the booking system when it launches next Monday and, if they've already booked with a hospital or municipality, not to double-book. Fat chance.

Meanwhile, Toronto is still in near-lockdown (no public places open, no in-restaurant dining, limits on customers in essential and non-essential stores) and the province is preparing field hospitals for a possible third wave due to the new variants.

I wanted to be explicit about all this so that my U.S. classmates don't think I'm always portraying a northern utopia, especially in health care.


Rick Millward said...

Universal health care would still be a better way to deliver services than the mess we have here now.

Clearly, we were utterly unprepared to vaccinate 325 million Americans but that's on the Republicans. They had a year to prep sites and procedures while the vaccine was being developed, but they did nothing...nothing...nothing. When the new administration took over, thankfully, it was start from scratch. They are doing the best they can to get people vaccinated as quickly as possible, but can't take the time to set up a uniform system, so we have the patchwork of clinics, pharmacies, and so on out of expediency.

When you complain at least place blame in the right place.

This is like fighting a war, but without a national defense, and having Jackson County raise it's own army and send it into battle without a general.

In my view there was one person who could have been sounding the alarm regarding this but he sat on his hands, opting to keep his job rather than rock the boat. Fauci. If he had resigned and become an advocate for the public rather than himself, we may have been better prepared. Democrats could have made vaccine delivery an issue as well, but their focus on the election, rightly, pushed it to the sidelines. It seems no one in government was thinking ahead. Wouldn't Fauci's "U.S. National Institute of Allergy and Infectious Diseases" be the logical organization to coordinate a national vaccination strategy?

If Republicans were still in control things would undoubtedly be worse...a vaccine black market, vaccine shipments diverted to Saudi Arabia in the dark of night, and, like Florida, wealthy donors cutting the line.

I would hope we prepare for the next pandemic, and it's coming be sure of that, by putting in place a dedicated national vaccine delivery system. Oh, and universal health care; if this hasn't shown us the urgency of that, what will?

The way some people gripe makes me wonder what lack of imagination keeps them from appreciating the miracle that we have vaccines at all.

Anonymous said...

Listening to Morning Joe this morning. Joe Scarborough, as watching Biden's speech, kept saying to the TV image of Biden on the screen, do not tell Americans to sign-up on a national website to get your Covid vaccine. Just then Biden announced a national website to sign Americans up for their Covid vaccine appointment. What can go wrong? It seems they did not learn all the lessons of the ACA rollout.

Art Baden said...

Not building a national website because something could go wrong is equivalent to not building a ship because it might sink.

M2inFLA said...

Last August, the administration said that a vaccine would be available by the end of 2020. They told the states to set up a process to administer the vaccines. Unfortunately, the states did not listen, as they waited for delivery of vaccines to start administering them.

As with the ACA signup, each state eventually created a system for signups and administering the vaccines. Some successfully, some not.

I was lucky to be in Florida. Got my wife and me signed up in early January; got 1st Moderna in a few days; got 2nd in early February with no side effects.

Since then, as news spread, more and more systems and sites were set up, and it's been reported that more than half of those 65+ have received at least one of the vaccines here in Florida.

In recent weeks, there are hundreds if not more places to get either the Pfizer, Moderna, orJ&J vaccine. Clinics, drive-thrus, grocery stores, and drugstores.

It all could have been done quicker, but some states are still stumbling. Next step is to reach those in care and assisted living facilities, as well as helping those who aren't quite computer or phone literate.

I can understand why there was reluctance to start earlier, but we've all learned a lesson. Perhaps in the future, competency can be recognized and shared. Each state could learn from this episode.

What we don't need us a federal bureaucracy to handle what is actually a state and local issue.

PS I was an Oregon resident for 45 years, and still care a lot. Nice to be able to compare how things are being run from a different viewpoint.