SIMS: Better plan needed to vaccinate frontline health-care workers

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Dr. Michael Fernando will be on the job in the emergency department at Four Counties Health Services Friday morning, but still without a COVID-19 vaccination.

Fernando, a physician in a family health-care clinic in Aylmer, also works as an ER doctor in Newbury. As a front-line hospital worker, he was a top priority to get the vaccine, until Thursday.

He’d been waiting to hear about his appointment from London Health Sciences Centre, which is managing the regional program; however, an administrative error at his hospital inadvertently left him off the list.

When he called Thursday to book an appointment, he was told he was out of luck for now. New provincial directives made long-term care residents and staff the priority, and pushed front-line hospital workers back in the queue.

“The concern is I don’t know when I’m going to get vaccinated now,” Fernando said. “The amount of exposures that happen between now and when I do get vaccinated are potentially unnecessary exposures and I think that’s what bothers me.”

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There’s little argument that the Ontarians in long-term care need to get vaccinated pronto. At the Middlesex-London Health Unit’s media update Thursday, medical officer of health Chris Mackie said long-term care makes up 60 per cent of Ontario’s COVID-19 deaths, even though the residents make up less than 10 per cent of the population.

Though there’s “no doubt that every one of those health-care workers and beyond deserve to get the vaccine as soon as possible,” Mackie said this was a provincial decision that has the support of the hospital and the health unit. Vaccinating our most vulnerable will save more lives.

We are a month past the first deliveries of the Pfizer-BioNTech vaccine in Ontario, but distribution has been painfully slow. As of Thursday, the first day of stay-at-home orders, there had been only 159,021 vaccinations in a province of about 15 million people.

A limited supply means rationing to those who need it most. The persnickety Pfizer-BioNTech shots require sophisticated logistics because of the super-cold storage temperatures necessary to store it. The much more mobile Moderna vaccine was supposed to be here, but local rations were redirected to Ontario’s virus hotspots.

Mackie said it will take four to five weeks to vaccinate long-term care homes in the Middlesex-London, Huron-Perth and Southwestern health unit regions. Then it’s retirement homes and it won’t be until April until they open up to the next stage.

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While the vaccine is deployed out to long-term care, the Western Fair Agriplex is still a vaccination clinic, but hospital officials said they will scale it back.

That timeline leaves me and Fernando, who has a master’s degree in public health, a bit gobsmacked and a lot worried. Scaling back already “is a bad sign,” he said.

“I just see this chasm of what needs to be done and what’s being done and think, ‘Oh my gosh, we’re so far behind,’ ” he said.

Fernando said he would have preferred that health units, who are vaccine clinic whizzes, were managing local programs rather than the hospital.

Long-term care homes “are a mere whiff of what needs to get done,” he said. Meanwhile, if a sick person shows up in Fernando’s emergency room, the doctor could get infected and the whole hospital if the patient is admitted.

There’s a good case for front-line workers, especially hospital workers. Fernando quoted American virologist Dr. Anthony Fauci: “You don’t want to be that last guy on the battlefield before the treaty is signed.”

The supplies are in a trickle right now, but Fernando said expect a firehose of vaccine in the near future.

“One of the advantages of mRNA vaccines is that they can make it very quickly and they can make a lot of it. Today we might not have enough vaccine, but tomorrow the problem is going to be we have too much vaccine.”

It will be difficult to explain to a public begging for shots, why that vaccine is sitting in freezers while more people die.

“That’s going to be the thing that’s makes us realize whether we succeeded or whether we failed,” Fernando said. “The way things are going we’re looking failure in the face.”

Or a logistical emergency that needs some dramatic intervention.

jsims@postmedia.com

twitter.com/JaneatLFPress

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