Wendy Cox & James Keller | Vancouver and Calgary | Published: April 24, 2021
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Good morning. It’s James Keller in Calgary.
Since the early days of the COVID-19 vaccines, the approach across Canada has been simple: Prioritize long-term care residents and other people in their advanced age, health care staff, those with underlying conditions, and some front-line workers. Then, move down from there by age.
But there have been growing calls from public-health experts to switch gears, focusing instead on the communities most at risk. That includes neighbourhoods that have become hot spots, like the Jane and Finch area of Toronto, or Whalley and West Newton in Surrey, B.C. These areas are often racialized communities, where people work risky front-line jobs before coming home to multi-generation homes. It’s a population that has been particularly at risk throughout the COVID-19 pandemic.
B.C. announced plans this week to target 13 neighbourhoods, mostly in the Lower Mainland and one in Dawson Creek. Anyone over 40 in those neighbourhoods is eligible for the AstraZeneca vaccine, and health officials have set up additional clinics to ensure people can get their shots.
Those neighbourhoods include 27 forward sortation areas – the first three digits of a postal code – and census data show that 19 of those have visible minority populations above the provincial average.
The province has also targeted several communities for mass vaccination because of high infection rates, beginning with Prince Rupert and more recently targeting Whistler and Tofino.
Katie Crocker, chief executive officer of the Affiliation of Multicultural Societies and Service Agencies of B.C., said the data has been clear throughout the pandemic that neighbourhoods with high proportions of working-class, racialized people are bearing a disproportionate burden from COVID-19. She said that includes hot spot neighbourhoods in Surrey, where there is a large proportion of South Asian residents, and places like Whistler, where temporary foreign workers make up a large share of the hospitality work force.
“The communities of people who are in grocery stores, who are in meat-packing plants, who are growing our food, who are doing all the things that the rest of us need to be able to work from home, they’re the ones that are out there on the front line,” said Ms. Crocker.
“For me, it was a relief to see that finally somebody’s paying attention to how important these folks are to the operations of this province.”
She added that the province should ensure that people of all ages in the hot spot neighbourhoods are included, not just people over 40, by using vaccines other than AstraZeneca.
Prince Rupert had a relatively mild experience with COVID-19 until infections started to flare up in February and March, giving the city among the highest per capita infection rates in the province. There were cases in the community’s long-term care facilities and exposure alerts in schools and homeless shelters.
Health officials responded with a plan to offer vaccines to the city’s roughly 12,000 residents, regardless of age, health condition or occupation..
The plan has been a remarkable success. Before the vaccine program, Prince Rupert was recording nearly 120 COVID-19 infections per week. About 85 per cent of the community received first doses of the Pfizer-BioNTech and Moderna vaccines in the span of eight days.
Last week, Prince Rupert had just three new COVID-19 infections.
Councillor Blair Mirau, who received his vaccine during the mass vaccination campaign, said the Prince Rupert experience is “proof of concept” that targeting hot spots works.
Northern Health is also using the community immunization model on Haida Gwaii, while Island Health says all residents of nearly 30 communities with populations under 4,000 or with accessibility challenges, such as the Gulf Islands, will also be vaccinated together in one- or two-day clinics.
Manitoba announced Friday that it would offer vaccines to any adult living in three neighbourhoods of Winnipeg with high infection rates, as well as people working in those areas in settings such as schools, daycares, grocery stores and food-processing facilities, among others.
Alberta has taken a different approach, opting against targeting specific, high-risk neighbourhoods.
The province’s Chief Medical Officer of Health, Deena Hinshaw, said the province’s infection rates are so bad everywhere that it wouldn’t make sense to target specific communities or neighbourhoods, which she said would divert vaccines from high-risk groups that need it more.
There are some areas with significantly higher rates than the provincial average, including the far northeast corner of Calgary. The neighbourhood has the highest rates of active and new infections in the province’s two largest cities and is nearly twice the provincial average. Nearly 1 in 10 people in that neighbourhood have had COVID-19 at some point during the pandemic.
Gabriel Fabreau, who teaches medicine at the University of Calgary and is a doctor at the Peter Lougheed Hospital in northeast Calgary, said Alberta’s resistance to targeting hot spot communities is an example of the province lagging the science. He said there is solid research out of Ontario that vaccinating people in neighbourhoods with high rates of spread can have an impact on overall transmission, as well as protecting vulnerable groups – often people of colour working risky front-line jobs – from the worst effects of COVID-19.
“Hot spotting neighbourhoods that are most affected and hot spotting high-risk workplaces makes sense scientifically, and it makes sense to address our out-of-control third wave – it will almost certainly reduce infections, reduce hospitalizations and deaths,” said Dr. Fabreau.
“That’s an ethical issue that we’re going to have to deal with in Alberta as we watch other provinces like Ontario and B.C. pivot a lot faster than us.”
Dr. Fabreau, who also works with Refugee Health YYC out of the University of Calgary’s O’Brien Institute for Public Health, was part of a team of doctors that organized a vaccine clinic at the Cargill meat-packing plant near High River, Alta., where an outbreak led to roughly a thousand cases and three deaths last year.
The clinic, which was scheduled for this weekend, was delayed because of a shortage of Moderna vaccines. It has yet to be rescheduled, though Alberta Health says that will happen as soon as possible.
Dr. Fabreau said the Alberta government response to the shortage, cancelling the Cargill clinic rather than diverting vaccines from other areas, such as second doses that could be delayed, says a lot about the province’s priorities.
This is the weekly Western Canada newsletter written by B.C. Editor Wendy Cox and Alberta Bureau Chief James Keller. If you’re reading this on the web, or it was forwarded to you from someone else, you can sign up for it and all Globe newsletters here.