By Mike Baker

While rollout of the COVID-19 vaccine is well underway in some parts of Ontario, one local doctor, as well as the acting medical officer of health for the Haliburton, Kawartha, Pine Ridge District Health Unit [HKPRDHU] are warning Haliburton County residents that it will likely be “many months” before a vaccine is readily available in our area.

In a phone interview with the Times last week, Dr. Ian Gemmill, the acting medical officer of health with HKPRDHU, outlined exactly how the vaccine is being released across Ontario and why it’s going to take so long for doses to reach our region.

“The province of Ontario are the ones making the vaccine available to the public, and it’s going to be done via a schedule of priorities. Those sets of priorities are being devised by a vaccine task-force,” Dr. Gemmill said. “Where we are right now, the plan is to implement this in different phases.”

Phase one launched on Dec. 14, 2020 when more than 2,500 healthcare workers who provide care in select long-term care homes and hospitals were vaccinated at the University Health Network in Toronto and The Ottawa Hospital. In the weeks since, the government has distributed approximately 90,000 of the Pfizer-BioNTech vaccine and 50,000 doses of the Moderna vaccine to 17 hospital sites across the GTA, London, Ottawa, Windsor and Thunder Bay. The vaccine was made available to healthcare workers, essential caregivers, long-term care home and retirement home residents and First Nation communities and urban Indigenous populations within those areas.

Under phase one, the Ontario government estimates that more than 20 hospitals across the province will be administering the COVID-19 vaccines.
“These vaccines – not a lot of it is being delivered to Canada right now. There simply isn’t enough to cover everyone in Ontario, far from it,” Dr. Gemmill said. “The first geographical areas being done are areas with the highest preponderance with coronavirus – so places around the GTA, and other areas like Ottawa. With the limited amounts of the vaccine we have now, that’s where the focus is.”

He added, “Right now, Haliburton, Kawartha, Pine Ridge, and our communities, are not on that list. We have not yet been notified of the availability of the vaccine for our critically-important groups for our area, but have been notified to be on stand-by. Things could change on a day’s notice.”

Dr. Norm Bottum, from the Haliburton Highlands Family Health Team, believes it could be mid to late February before all frontline workers and long-term care residents in Haliburton County are administered a vaccine.
“That’s my hope, but I don’t know if that’s more wishful thinking,” Dr. Bottum noted.
While the public health unit will be involved in an advisory capacity in the gradual rollout of the vaccine to frontline workers and long-term care residents, Dr. Gemmill said most of the leg work would likely be done by Haliburton Highlands Health Services (HHHS), since the vaccines will be delivered to and stored within the facility’s freezers.

Carolyn Plummer, president and CEO of HHHS informed the Times that the hospital has not yet been given any details regarding timelines for the initial number of vaccine doses that are to be received in Haliburton County.

“We have been advocating strongly to receive the vaccine sooner rather than later, particularly with the recent rise in COVID-19 cases in our area,” Plummer said. “Our community has done a wonderful job so far in helping to keep the prevalence low, and all the healthcare providers in our community have been working tirelessly to keep our patients, long-term care residents, and many others in the community as safe as possible – so we are doing everything we can to make sure the vaccine is made available as quickly as possible to support these efforts.”

Phase two will begin when more doses of the vaccine become available in Ontario, and will be expanded to include additional congregate care settings, such as homeless shelters, and adults over the age of 70 in select regions. According to the Ontario government website, the province’s task force, led by retired military general Rick Hillier, will use ethical framework and best available data to identify other priority populations, notably lower age groups, within phase two, based on available vaccine supply.

While the government says phase two will likely be implemented this winter, Dr. Gemmill believes a more realistic likelihood is that it will be stretched out to the summer.
Things could change, Dr. Gemmill says, if the federal government approves further vaccines, such as the AstraZeneca vaccine that has been developed at Oxford University in the UK.
“There is not just one vaccine for COVID-19, there are several vaccines. It just so happened that the first ones approved [in Canada] required freezing,” Dr. Gemmill said. “I’m very hopeful that we’re going to have different vaccines available soon. One for example, Oxford’s AstraZeneca, is not yet licensed, but is fridge stable. That is going to change everything. We wouldn’t have to worry about freezers. That vaccine would allow us to do mass campaigns in the same way we do influenza vaccines every year. That would make things much, much easier.”

The UK became the first country to approve the Oxford AstraZeneca vaccine on Dec. 30, with the first dose administered just a few days later. Ontario Premier Doug Ford has called on Prime Minister Justin Trudeau to approve its use in Canada and secure doses so that it can be rolled out to residents who want and need it.

One of the major benefits of the AstraZeneca vaccine, Dr. Gemmill says, is that it can be fully administered in a single dose, while both the Pfizer and Moderna vaccines require two shots given several weeks apart.
Before Christmas, the feds exercised options to purchase 20 million doses of the Pfizer vaccine and 40 million doses of the Moderna vaccine.

Procurement Minister Anita Anand informed CBC on Sunday [Jan. 10] that the government had chosen not to exercise a further option to purchase an additional 16 million doses of the Moderna vaccine.
Anand said the doses the Canadian government had already ordered would ensure that anyone who wants the COVID-19 vaccine will be able to receive it by September.

A third and final phase of vaccine distribution here in Ontario will kick in once there are enough doses available for anyone who wants to be immunized – likely late summer, or early fall.

With around 11,000 patients across Haliburton County, at least half of them over the age of 65, the Haliburton Highlands Family Health Team is the community’s largest family clinic. Staff have been inundated with calls in recent weeks as residents try to find out when they can get their shot.
“We have a lot of seniors. I don’t have an exact number for you, but we have the highest percentage of seniors to population anywhere in the province. We have a lot of people over the age of 80 who still live at home doing what they can to keep mentally and physically fit, waiting for the vaccine to come,” Dr. Bottum said.

He continued, “The government has committed to trying to get people in Canada immunized by September, but that’s still nine months away. For many people, it’s probably going to be July, August, September by the time we have enough vaccines to give to people. So the general public, I would say, will probably have a long wait ahead of them.”

Dr. Gemmill informed the Times that, to the best of his knowledge, there had been zero vaccines administered thus far in Haliburton County. We were able to identify one former area resident, Kristen Bell, as having recently received the vaccine. A registered nurse whose parents were longtime residents of the county, Bell was given her shot at a clinic in Barrie last week.
“The process was really easy… and took very little time. It was just a consent, quick jab and [staff] watch you for 15 minutes to make sure you are ok. I’ll go back to receive my second shot in two weeks,” Bell told the Times.

Even though she was among the first percentile of Ontarians to receive the new vaccine, Bell says she wasn’t nervous at all to get the shot.
“It is important for me to become vaccinated to protect myself, my family and the vulnerable populations I care for on a daily basis. The more people who are vaccinated, the less community spread we should see,” Bell said. “These vaccines are well researched and I have to put my trust in this research. Without vaccines we cannot control this disease.”

Dr. Gemmill offered his opinion that the COVID-19 vaccines presently on the market were “quite safe.”
“The only indication saying you shouldn’t get the vaccine is a previous life-threatening allergic reaction to any of its components,” Dr. Gemmill said. “Right now, there have been hundreds of thousands, if not millions of doses given across the world. I’ve heard of a couple of situations of allergic reactions, but they seem to be very uncommon. It is quite a safe vaccine. I don’t foresee there being any major difficulty [for people getting it].”

In his research, Dr. Bottum said he found one report that states the incidence rate of allergic reaction to the COVID-19 vaccines on the market is five per million, while another report outlines a slightly higher rate, at 11 incidents per million.
“The odds of having a reaction are pretty small. The odds of us getting one in Haliburton County, if we’re going off 11 in one million, there may be one to get a bad allergic reaction, so I think people are pretty safe. We just need to be careful about it,” Dr. Bottum said.

When available, the COVID-19 vaccine will be free to all Ontario residents, Dr. Gemmill confirmed. As of 10:30 a.m. on Monday [Jan. 11], there had been 122,105 total doses administered across Ontario, with 5,884 vaccinations considered complete.
Updated COVID-19 statistics provided some grim reading over the weekend, with Ontario reporting a record-high new COVID-19 case count on Sunday, with 3,945 new cases and 61 new deaths. As of press time, Ontario had 30,632 active cases of COVID-19.

Here in the HKPR district health unit there are 70 active cases – three in Haliburton County, 38 in the City of Kawartha Lakes and 29 in Northumberland County, with one additional “probable case” in the Kawarthas. There are a further 101 high-risk contacts across the region, with two of those located here in Haliburton.

Both Dr. Gemmill and Dr. Bottum reiterated the same line of messaging, asking that local residents respect the rules of Ontario’s current lockdown, in place until at least Jan. 23, and stay home whenever possible.
“I think we’re seeing the repercussions now from the Christmas break. Hopefully by next week we will see some reduction in the numbers, otherwise the lockdown could go on even longer,” Dr. Bottum said. “There were a lot of cases over the holidays, and it was down to people gathering with family and friends.”

Dr. Gemmill added, when referencing the increased number of cases in recent weeks, “It’s definitely down to people who are travelling, who are gathering unnecessarily for social situations. Don’t travel. Don’t gather, because that’s what’s driving the spike at the moment. Until we get the vaccine, that’s what we need to do.”

Dr. Bottum noted that his patients would be informed as soon as they’re able to be vaccinated, while Dr. Gemmill hinted there would be a campaign to ensure even those without family doctors would be notified when the vaccine becomes readily available.
“Let’s look at 2021 as the year of getting our population immunized against this virus and stopping it in its tracks. I don’t think we’ll completely get rid of the virus, but certainly we will be able to control it,” Dr. Gemmill said. “The vaccine is the bright light at the end of the tunnel, and I’m very excited that over the next few months we’ll be able to offer this vaccine to anyone in Ontario that wants it.”