Monday, December 7, 2020  |  Category: Eduvation Insider

Winter of Discontent, but Autumn of Hope?

Good morning!

I don’t want to make your Monday worse, but it’s time for my weekly pandemic roundup, and as you would expect things are sliding downhill fast. Much though some politicians would like to deny it, COVID is spreading into new, unprepared regions across North America, from rural Alberta and Ontario to Eastern Quebec. We’re on track for a very long, bleak winter across North America – and none of us should be risking our families over the Christmas holiday.

But the good news is that we can look forward to NEXT Christmas with considerably more optimism. Today I’ll also take a look at the details we have regarding the distribution plans for the vaccine, and the implications for the Fall 2021 term. (Hint: it’s too close to call!)

 

Global Pandemic

Divergent Realities

The COVID19 pandemic has now surpassed 66 million confirmed cases worldwide, with 1.5 million deaths – and pandemic waves are flooding and ebbing from nation to nation. The UK’s COVID19 death toll, 60,113, is now the highest in Europe. Germany’s “lockdown light” has proven inadequate to the task, and hospital ICUs are approaching capacity. France and Belgium have brought their second waves under control. India has seen fewer than 50,000 new cases every day for the past month, and fewer than 40,000 for the past 4 days. While the Philippines and Vietnam have flattened their curve, Indonesia and Thailand are seeing alarming increases in cases – and Indonesia has one of the lowest testing rates in the world. New restrictions are coming into effect in Wales, Italy, and South Korea, while they are being extended in Germany, and relaxed in Ireland,Spain, and the Czech Republic.

Epidemiologists are increasingly emphasizing that short, complete lockdowns are the best way to bring COVID19 spread under control, with the least damage to the economy. Anti-lockdown protestors and right-wing governments, however, continue to argue for half-measures that ultimately cause far more harm to health and commerce.

“Staying home is a privilege of the wealthy and of wealthier governments. If countries don’t have the resources to do that, telling people to stay home and starve to death is not a realistic option.” – Jeremy Lim, Assoc Prof of Public Health, National University of Singapore

 

US Pandemic

#1 Cause of Death

With about 3,000 deaths a day, 2 Americans are dying of COVID19 every minute, and it has become the #1 cause of death in the country. As of last night, the US had recorded 15,152,536 cases of COVID19, 101,190 people were hospitalized, and 288,886 had died – and as Anthony Fauci observes, the results of Thanksgiving dinners and travel have yet to be felt. Current CDC models suggest that 19,500 Americans could die of COVID19 during the week of Christmas alone.

“The reality is that December, January and February are going to be rough times. I actually believe they’re going to be the most difficult time in the public health history of this nation.” – Robert Redfield, Director of the CDC

 

The largest US case counts are in Texas, California, Florida, and Illinois, while the highest death rates are in South Dakota, North Dakota, and New Mexico. South Dakota is so short on ICU capacity that some COVID19 patients are being flown out of state for treatment. In California, where cases have tripled in the past month, governor Gavin Newsom imposed a new stay-at-home order on regions with fewer than 15% of ICU beds available – and indicated that 4 of the state’s 5 regions could pass that threshold “within a day or two.” (Retailers are already protesting the “catastrophic” loss of revenue in the holiday shopping season.)

President-elect Joe Biden cannot impose national health restrictions, but is urging Americans to wear face masks for the first 100 days of his presidency. Former presidents Barack Obama, George W Bush and Bill Clinton have committed to receive their vaccinations on camera, to reassure the public. Meanwhile Donald Trump announced yesterday that his personal lawyer, Rudy Giuliani, has tested positive, after weeks attending Republican rallies, strategy and legal sessions unmasked.

 

Canadian Pandemic

Canada continues to see cases climbing, well past 400,000 now, and the latest forecasting model from SFUsuggests “we could have 10,000 cases daily by January.” Some Atlantic provinces may soon be able to ease up on health restrictions, as cases start declining in Nova Scotia, New Brunswick and Newfoundland – but the Atlantic Bubble likely won’t be re-established until the new year. PEI is concerned about small outbreaks at 2 fast food outlets in Charlottetown, and in fact announced a 2-week “circuit breaker” lockdown last night, to stop the spread after hitting just 11 active cases.

Meanwhile, Canada’s larger provinces are repeatedly setting records for new daily COVID19 cases, hospitalizations or deaths, including Ontario, Alberta, Manitoba, BC and Quebec. (Things are probably worse than we know: it was discouraging to hear that a bug in the federal COVID Alert app left many users completely uninformed for half of November.)

In many regions of the country, the pandemic is spreading to suburban and rural regions where people have generally felt a false sense of security – but have no immunity, and limited access to healthcare. It’s “deeply concerning,” says Theresa Tam, “that case numbers are rising in remote areas of the country where health services are not adequately equipped to manage complex medical emergencies.”

“Now is not the time to blame one another or point fingers. Now is the time for us to keep working together.” – Justin Trudeau, Prime Minister of Canada

 

Alberta currently has more active cases than any other province. CMOH Deena Hinshaw is warning that infection rates are rising in rural Alberta, but premier Jason Kenney stubbornly insists that tougher restrictions will be focused on the “hot zones” of Calgary and Edmonton. One uCalgary medicine prof warns that much stricter restrictions will be necessary.

“We’re entering a very scary phase of this wave of the pandemic… The lockdown measures needed for us to interrupt this incredible acceleration we’re on are going to be so much stricter than what we could have faced if we responded weeks ago.” – Christine Gibson, Asst Prof Medicine, University of Calgary

 

Manitoba has more active cases per person than any other province. Premier Brian Pallister imposed a partial lockdown across the entire province on Nov 12, closing churches, nonessential businesses and in-restaurant dining to try to prevent the “extreme worst-case” scenario from further unfolding. 3 weeks later, it appears to be helping, bringing cases down from the “extreme” range to merely the “severe” range on some days. The province has recently been shaken by the COVID19-related deaths of a young boy under age 10, a woman in her 20s, and a young man in his 20s.

“I’m the guy who’s stealing Christmas, to keep you safe.”- Brian Pallister, Premier of Manitoba

 

In Ontario, most cases are concentrated in already-locked-down Toronto and Peel, but rapidly climbing cases are leading to new alert levels in York Region, Waterloo, Hamilton, London, Thunder Bay, and others.

Although Quebec’s first wave this spring hit the Montreal region hardest of the entire country, the second wave this fall has impacted eastern Quebec even worse. While Montreal learned from its traumatic experience, those who wanted to escape strict public health rules may have fled east, “sowing what resulted in death a few months later.” One mayor in the Laurentians is urging Montrealers not to try holding large gatherings up north, and even asked the province to establish police checkpoints. On Sunday, the province surpassed 151,000 total cases. Healthcare professionals are naturally concerned about the potential for even worse outbreaks after the Christmas holidays: “You have to ask yourself if it’s worth taking the risk, to end up at the funeral home 4 weeks later.” Premier François Legault has already “torn up the moral contract” he proposed that might have allowed Christmas gatherings.

 

COVID on Campus

CdnPSE reported 34 new cases of COVID19 since Friday. (You can see the complete tally in my CdnPSE spreadsheet.) By far the toughest situations have been at uCalgary and Western, where campus hospitals have seen massive outbreaks…

uCalgary reported 3 more cases, at the Foothills campus Health Sciences, Sports Medicine Centre, Mac Hall, Earth Sciences and Sciences B buildings. (Total 135 cases this fall, by my count.)  UC

Durham College reported a new case at its Oshawa campus Friday (bringing their Fall total to 33).  DC

Loyalist College reports 4 new cases in the campus community, of which just 1 had been to campus. (Fall total 8.)  Loyalist

Olds College reports another positive case on campus (bringing their Fall total to 6).  Olds

Ryerson U has reportedly documented its 13th case on campus.  Ryersonian

St Lawrence College reports that a student living in its Kingston residence tested positive and is self-isolating (bringing their Fall total to 7).  SLC

uWaterloo reports 1 new case on campus (bringing their Fall total to 14).  UW

Western U’s University Hospital outbreak, almost a month old now, is making international headlines for a staff potluck that the CEO now says did not happen, although inadequate space for staff breaks and improper use of PPE were issues. Despite their best efforts to contain the outbreak, UH reported on Saturday that it had spread to a 7th unit on yet another floor, along with 22 new cases and 2 more fatalities. So far 70 patients and 56 staff have tested positive, and 13 have died. (Western students off-campus and in 3 residence outbreaks have also totalled another 82 cases or more, for a total of 228 this fall.)  CBC

“We are human, we are fallible and we are tired.” – Paul Woods, CEO, London Health Sciences Centre

 

Prospects for Normalcy

This December, adults are watching vaccine delivery timelines and supply chain rehearsals with the sort of anxious hope normally reserved for kids watching the NORAD Santa radar…

Vaccine for Christmas

Health Canada’s review of the Pfizer vaccine is “progressing really well,” and may be complete in the next week. The US FDA plans to meet Dec 10 to discuss emergency use authorization. Then the Moderna vaccine is expected to secure regulatory approvals. The other 2 front-runners, AstraZeneca and Janssen, still need to provide “large chunks of information.”  CBC

BioNTech says shipments of the Pfizer vaccine to Canada could start “within 24 hours” of Health Canada’s approval, expected within “the next week.”  Globe & Mail

In the UK, where the Pfizer vaccine has already been granted approval, 94-year-old Queen Elizabeth II and her 99-year-old husband Philip are expected to be immunized within weeks.  CTV

“All along the way Canadians have made sacrifices and despite a still long road ahead, there is some good news on the horizon. An initial supply of vaccines is expected to become available in early 2021 and although supply will be limited at the outset, Canada is well-positioned to provide access to safe and effective COVID-19 vaccines for all Canadians.” – Theresa Tam, Canada’s Chief Public Health Officer

 

Summer Vacation Vaccinations

Although COVID19 vaccines will start arriving in North America by the end of December, vaccinations will be prioritized and supplies will be limited. In the first quarter of 2021 (Jan-Mar), 3 million Canadians should get vaccinated in Phase 1, which will focus on at-risk populations, including residents and staff at long-term care homes, and other healthcare workers. (Of a total 38M Canadians.) In Alberta, for example, phase 1 is expected to reach 10% of the population, or 435,000 people. In Phase 2 (Apr-Jun 2021), Alberta hopes to have 30% of the population immunized – but still on a prioritized basis. Most PSE students and younger faculty or staff won’t be offered the vaccine until Phase 3, starting in about July 2021.  CBC

 

Black Market Vaccines

Here’s a depressing thought from those optimists at Interpol: “high demand combined with a limited supply will make COVID19 vaccines the equivalent of liquid gold to organized crime networks.” Criminal organizations are already attempting to disrupt supply chains through phishing and cyberattacks.  Interpol

 

Stopping Transmission

While we wait for vaccines to roll out, researchers at Georgia State U report that Molnupiravir, a new antiviral drug developed at Emory U, appears to suppress “completely” COVID19 transmission in just 24 hours. (At least, in ferrets.) And for those afraid of needles, it’s “orally available.” The drug is currently in phase III trials.  Entrepreneur

 

 

Herd Immunity By Fall?

The latest McKinsey & Co projections are that the US will achieve herd immunity, with 60-70% of Americans immune, in Q3 or Q4 2021. Oxfam projects however that 61% of the world’s population won’t get a vaccine until 2022. And true recovery for the economy and international mobility will also need to overcome psychological hurdles. “The pandemic will end one mind at a time.”  ICEF

 

Discretion is the Better Part…

Normally, Phase III clinical trials have taken place over several years and longer-term or subtler side-effects have surfaced before a new vaccine is approved for general use. In the case of the COVID19 pandemic, however, the devastation to health, life and the economy means that governments worldwide are fast-tracking the “cure” – at “warp speed” as the Trump administration dubbed it. With just tens of thousands of participants, and poor representation from some minority groups, young children or those with rare conditions, it is possible that rare side effects will emerge only after the vaccines roll out to millions of people. Experts assure us that the benefits “far outweigh” the risks, but many will remain cautious at first (not just the anti-vaxxers). Most side effects arise within 2 months of immunization, and so far they appear to include fatigue, headaches, fever and muscle or joint pain.  Newsweek

“There are real risks that come with choosing not to get vaccinated, and these are likely to be much, much greater than any risk from having the vaccination.” – Edward Hutchinson, Centre for Virus Research, University of Glasgow

 

So… Fall 2021?

How prepared we will be for a “normal” Fall term will depend on the speed with which the vaccine supply chain can be ramped up, and immunizations take place. Each province will determine its own approach and prioritization, and as Theresa Tam warns, “there are so many different parameters and uncertainties, we just have to be prepared for unexpected things to happen.” Antony Fauci predicts that the US will start seeing dramatic improvements in the pandemic in Q3 of 2021, or around August.

So, September is still up in the air. I suspect we can assume some de-densification and masking protocols will still be necessary for the Fall 2021 term on campus – but there is some hope that Fall 2021 could be more on-campus than the preceding 20 months!

 

Thanks for wading through all that!  I hope it proves to be the toughest part of your week.  Stay well,