We have lived in a world of Covid for nearly 2 years.  That seems hard to believe.  Many of us want our lives back. I am one of those people. Yet, it doesn’t seem I will get it back anytime soon. That makes many people mad. Some people want all restrictions removed. They feel the restrictions penalize the young and healthy  and believe we should concentrate on protecting the vulnerable and letting the rest live. Others think the restrictions are not harsh enough.

Recently a friend of my was very angry with how Canada was dealing with the pandemic. We should learn from Germany he said. They don’t imposed restrictions like we do and they are doing better than we are.  Then–just a couple of days later–I heard Germany was the new hotspot for Covid, the worst place in Europe if not the world for Covid.

One thing I have learned during the pandemic is that it actually does move like a wave.  People see it coming at them, and then as soon as the wave passes they think they are done. It’s over and they are quick to declare. Then the next wave comes over us again and then another. Each wave often seems worse than the one that preceded it.

As Dr. Hans Kluge , the WHO Regional Director for Europe said, said, “too often countries have declared the pandemic over when it was just a wave waiting for the next wave.” Manitoba certainly made this mistake, as ddi Saskatchewan and Alberta,  but so did almost all jurisdictions.

Recently Europe has been hard hit.  Now before we point wagging fingers at Europe we must remember this virus travels in waves throughout the world. We could be next. Manitoba is not yet out of the 4^th wave!

We look at one state or one province or one country who is doing poorly in dealing with the virus and we are quick to wag our fingers and often we do it with deep feelings of superiority. Then it becomes our turn as the wave faces us.

Things change quickly. The only constant in the world of Covid is change. We should be used to that by now.

Vaccines are not useless, by a long shot!  But the figures we get from the province of Manitoba could be presented more effectively. Their numbers are deceiving. Tom Brodbeck of the Winnipeg Free Press described the problem well:

“If the province wants to show how effective COVID-19 vaccines are at reducing infections and hospitalizations, it should clarify the data it gives to the public. What it releases now in the regular infection and hospitalization reports is misleading.”

Here is the problems. The province displays the stats for Covid-19 cases by stating the total number of new cases and then dividing those into fully vaccinated, partially vaccinated, and unvaccinated.  The number of vaccinated people who get Covid-19 has been rising steadily in comparison to the unvaccinated people. Sometimes almost as many fully vaccinated people have caught the virus as unvaccinated. How can that be?  If you are not careful you might think that means the vaccines are not very ineffective.

What people forget is that the number of Manitobans who have been fully vaccinated has been increasing. I had a friend of mine ask me exactly the same question. It is easy to get fooled. The reason this is misleading is that the province doesn’t give us all the information we need.  Brodbeck explained the issue this way:

“The answer is that the proportion of fully vaccinated people who test positive, or require a hospital bed, is substantially lower than those who are not immunized.

For example, if the province reports 100 new infections and breaks it down between 60 unvaccinated and 40 vaccinated, it doesn’t appear there’s a big difference between the two. But when the proportion of those who are immunized and non-immunized is reported, a far more accurate picture emerges.

The 40 fully vaccinated people infected represent about four per 100,000 immunized people (there are 1.02 million fully vaccinated Manitobans). The 60 people who were not immunized represent about 17 per 100,000 unvaccinated people (approximately 360,000 Manitobans are not fully vaccinated) — just over four times higher than those with a double dose.”

 

Clearly your chances of getting Covid-19 are much higher for the unvaccinated people than the fully vaccinated people. That is because that 60% of new cases for unvaccinated people has a much smaller poor to draw from.

As Brodbeck added,

“It’s the same with hospitalizations. The province provides daily updates on the percentage of vaccinated and unvaccinated people who end up in hospital, including in intensive care wards. On Thursday, public health reported that 51 per cent of active hospitalizations were among the unvaccinated, three per cent were partially immunized and 45 per cent fully vaccinated. From those statistics, it doesn’t appear vaccines provide much protection. But as a percentage of those immunized, they do. The 39 fully vaccinated hospital cases represent four per 100,000 fully vaccinated people. The 44 who were not immunized represent 12 per 100,000 unvaccinated people, three times the rate of those fully vaxxed.”

The province is not trying to hide these figures; they are just not doing a very good job of presenting them. If they did a better job more people would understand that vaccines are very effective. Everyone should take them! This would be easy to do.  The Covid-19 team is doing a great job of protecting us. But they could do a much better job of selling themselves.

Brodbeck gave us another example:

“Instead of only reporting the 115 unvaccinated and 64 vaccinated COVID- 19 cases Thursday, public health officials could have added that 32 per 100,000 were unvaccinated and six per 100,000 were fully vaccinated. It would give the public a far more accurate picture of the effectiveness of vaccines.”

In other words, on a per capita basis unvaccinated people who caught Covid-19 on Thursday outnumbered fully vaccinated people who caught Covid-19 by more than 5 to 1!

Added to that, new Covid-19 cases are not the most important issue. Hospitalizations are much more important.  It does not matter so much if you get covid-19 but do not get seriously sick. That is really what vaccines are for. Most people who get seriously sick are unvaccinated and the number per 100,000 is much higher than for full-vaccinated people.

If the Covid-19 team could do a better job of communicating to us we would all benefit because more people would realize vaccines work.

Recall that the test for the vaccines on children from 5-11 in the US “only” tested 2,400 children. Is that enough? I wish the group had been longer but then the test would have taken longer.

Some people argue that the test of 2,400 is inadequate because the group should have been much larger. Much larger would be nice. But right now it is the best test we have. Parents can say the test is not big enough and we will wait for a larger test.  We must always remember that doing nothing is making a choice too. These parents are choosing the status quo. That also has risks, because there are no decisions that involve no risks when it comes to taking or not taking vaccines.

Such parents have to remember that a significant number of children die from Covid-19 if parents do nothing as they have been doing up to now. Until now they had no choice. Now they do. Canada just approved the vaccine for children aged 5-11. Now doing nothing is a choice. Is it the best choice?

I would suggest we rely on the best test we have. That test shows the vaccine is 91% effective in preventing serious disease in children. The evidence is not perfect, but that is a significant benefit for the vaccine. Parents who don’t allow their children to take the vaccine are depriving them of vaccine that best available shows that it would really help 9 out of 10 children improve their odds of avoiding serious illness.

We have to chose one or the other. We cannot make a choice to take no risks, because such a choice does not exist. People who do nothing are also taking a risk. Is it a smaller risk? Why?

Dr. Paul Offit used the example of the polio vaccine which most of us are too young to remember. Oldsters like I remember. It was a very dangerous disease that really scared a lot of young children like me in the mid-fifties. I was overjoyed when a vaccine was approved, and I could take it. I was so overjoyed I remember it about 65 years later.

Dr. Salk produced the vaccine with a team of scientists that he led.  In their scientific tests 200,000 people got the vaccine and 200,000 people got a placebo instead.  During the time of the tests 16 people died in the placebo group. None died in the other group where they got the vaccines. Dr. Salk was horrified that 16 people died in his view unnecessarily because he wanted to give the vaccines to them but couldn’t.

When it comes to risk, we must always ask what human price are we willing to pay for knowledge. There is always a price to pay for human knowledge. Sometimes the price is high, as it was for the 16 people who got the placebo instead of the vaccine. Please note I am not advocating for no tests of new drugs!  I also remember the thalidomide drug that devastating children around the world because it had not been adequately tested. It is a difficult decision to make when testing has gone on long enough. I understand that the recent testing for the Covid-19 pills were so successful the FDA  scientific team overseeing the tests cut short the testing because it was so overwhelming beneficial they did not want to withhold it any longer. .

When it comes to risk we have to ask ourselves when do we know enough to make a decision, because often, not making the decision, is actually making a decision. Sometimes that decision is the wrong one and people suffer needlessly.

We can never stop worrying about and analyzing risks. But we should listen to science. Not uncle Ernie.

It is obvious that in many places such as Steinbach and Southern Manitoba in particular, there  is the deep distrust of government, authorities, and science. As a result, such distrusters refuse to take vaccines, and increasingly it is obvious that no rational argument can persuade them otherwise.  That in fact is the hallmark of a religious belief. Faith is not moved by rational argument. If a belief has been arrived at by means other than reasoning and data arguments based on reason and data will be entirely fruitless.

Many people distrust the authorities for a variety of reasons. One of them is the vaccines had not been adequately tested because they have been approved so fast. So, they want to wait and see. ‘Why take a chance?’, they ask. I had one of such people tell me, ‘I will wait for you to take the chance. You can be the guinea pig.’ Sounds rational, doesn’t it? It’s not.

First, and most importantly, by now there is overwhelming evidence that vaccines are safe even for young people. But there is another more subtle reason.

Right now, this issue is becoming very important because vaccines for those aged 5 to 11 are the in the process of being approved. They have already been approved in the US I understand.  I heard paediatrician Paul Offit interviewed on Amanpour & Company on PBS. He is the author of the book You Bet Your Life. He makes some very interesting points.  As he said,

“You never know everything. The question is when do you know enough? You know enough to move forward with vaccines. You know that for the 5-11-year-olds, there have been 2 million cases in the age group.  You know that there have been 8,300 hospitalizations in the group, about one-third of which end up in the ICU and about one-third of those had no pre-disposing risk factor which would put them at risk of serious disease and that more than 100 children have died. You should know that this study was done with about 2,400 children showing the vaccine was 91% effective. And you know that as far as everything that most people are concerned about such as the fear of myocarditis, the heart muscle inflammation, it was less of a problem in the 12-15 year olds and that this group, the 5-11-year-olds is getting even less of a dose. So, is that enough?  Of the 18 people who voted on that from the FDA Vaccine Advisory Committee, pretty much everybody voted yes. 17 to 0 with one abstention. Those 17 people would never have voted yes unless they would be willing to give the vaccine to their own children. I can tell you that if any of my children were between 5 and 11 years old now, I would give them the vaccine in a second, because there are no risk free choices. There are just choices to take a different risk and doing nothing is a choice to do something—i.e. to take a different risk.”

By doing nothing your children, or you on their behalf, are taking the risk not to take a vaccine that has been scientifically proven to be very safe and effective! That is a big decision. That is not doing  nothing! And you are betting your child’s life on that choice you have made for them.

Most of us don’t like taking risks.  But sometimes we have no choice. When it comes to vaccines for children (or for ourselves for that matter) we have no choice to take no risks. Either way we are making a choice to take a risk and we can’t get around this no matter how much we would like to do that. We are on the horns of a big dilemma. So how should we make such an important choice?

We can look to Uncle Ernie who has been doing a lot of “research” on the Internet even though he has no training on how to do that or how to evaluate the results of the research. Or we can look for advice to the large number of well trained and educated scientists who are working collaboratively with other scientists around the world. I wouldn’t bet my life or my child’s life on Uncle Ernie or even on my own “research.” That is too risky.

As Dr. Offit put it,

“About the only thing you have on your side is science, reason, and data. So, some people that think for example the vaccine is dangerous for pregnant women or think that it causes infertility or that it alters your DNA. You can argue that with science, reason and logic, but for people who don’t reach this conclusion with reason or logic won’t be talked out of it with reason and logic.”

We have to take the risk we think is most reasonable to take. I know what that is for me. I would do the same for my children. Either way you are betting your life.  Or  your child’s life.

By now everyone in Manitoba knows the black sheep of the Covid family can be found in the Southern Health District where I live.

As Katie May and Carol Sanders reported in the Winnipeg Free Press: “The 14.5 per cent test positivity rate in the Southern Health region, revealed in provincial data Friday, is triple the province wide number.”

According to the health professionals this also means that there is more Covid-19 in the Community than they previously thought. Southern Health might be singled out for greater restrictions than the other regions of the province. Even though I am from Southern Health and am doubled vaxxed, I must admit that this makes sense.

For weeks now, not just a couple of days the rate of new infections has as high or higher than Winnipeg even though it has 5 times our population.  We are 5 times as likely to get infected in our district than Winnipeg! We also have the lowest rates of vaccine uptake in Manitoba.  It is clear as can be that vaccine are working. not perfectly but enough to be a life saver!

Our regions has been bad. We are the black sheep of the family. Why should the rest of the province risk contamination from us? Can you blame them if they don’t want to? Can anyone blame them if they want to impose greater restrictions on us?

I keep coming back to the pandemic because it is so very interesting. I learned recently that the global death toll from Covid-19 exceeded 5 million. The Associated Press reported it this way:

“The global death toll from COVID-19 topped 5 million on Monday, less than two years into a crisis that has not only devastated poor countries but also humbled wealthy ones with first-rate health care systems.

Together, the United States, the European Union, Britain and Brazil — all upper-middle- or high-income countries — account for one-eighth of the world’s population but nearly half of all reported deaths. The U.S. alone has recorded over 745,000 lives lost, more than any other nation.”

There are many interesting things about this pandemic. Some like the amount of vaccine hesitancy I would never have dreamed possible. Another is the fact that this pandemic, unlike so many others, is in some ways affecting the wealthy more than the poor. How can that possibly be the case?

The death toll has been prepared by Johns Hopkins Hospital in the US, and according to Carla Johnson, of the Associate Press, it rivals the numbers of killed in all battles since 1950 according to the Peace Research Institute in Oslo. It is also now the global 3^rd leading cause of death behind heart disease and stroke. Johnson also claims the numbers are probably underestimates on account of limited testing and people dying at home in many places.

Johnson reported an even more interesting aspect of this pandemic:

“What’s uniquely different about this pandemic is it hit hardest the high-resource countries,” said Dr. Wafaa El-Sadr, director of ICAP, a global health center at Columbia University. “That’s the irony of COVID-19.”

Wealthier nations with longer life expectancies have larger proportions of older people, cancer survivors and nursing home residents, all of whom are especially vulnerable to COVID-19, El-Sadr noted. Poorer countries tend to have larger shares of children, teens and young adults, who are less likely to fall seriously ill from the coronavirus.

Added to that, nearly 80% of the deaths are among the obese, and the wealthy parts of the world, like North America have an abundance of the obese. Thus there is good reason for the rich to be hit harder.

Yet the rich, as always, have some advantages too. Usually they have much better access to health care and drugs, but in this case there is no cure for Covid-19. There are only vaccines and these are largely held by the rich countries.

Yet inside the rich countries it is the poorer people who are hardest hit. As Johnson said,

“The seeming disconnect between wealth and health is a paradox that disease experts will be pondering for years. But the pattern that is seen on the grand scale, when nations are compared, is different when examined at closer range. Within each wealthy country, when deaths and infections are mapped, poorer neighbourhoods are hit hardest.”

In the U.S. Covid-19 has hit African Americans and Hispanic people more than whites. Probably that is because they are more vaccine hesitant because of historic distrust of government (for good reason in many cases) and the fact that more of them live in poverty and have less access to health care. In Canada, indigenous people have been hit hard, for similar reasons, but also because  a significant portion of them live in isolated communities were social contact is so extremely important and while many of them live in overcrowded housing.

There is another crucial issue—the wealth gap and hoarding of vaccines. As Johnson reported,

“Wealth has also played a role in the global vaccination drive, with rich countries accused of locking up supplies. The U.S. and others are already dispensing booster shots at a time when millions across Africa haven’t received a single dose, though the rich countries are also shipping hundreds of millions of shots to the rest of the world.”

Africa remains the world’s least vaccinated region, with just 5 per cent of the population of 1.3 billion people fully covered.

It is good that wealthy countries like the United States have donated huge numbers of vaccines.  But the figures above show that the rich countries as a group have not done enough. Some have called this a moral catastrophe.  U.N. Secretary-General António Guterres said, “This is a global shame.”

Not only that, this is creating a potential monumental disaster, because the longer the rich countries allow the virus to smoulder throughout the world the greater the chances of new and perhaps even more deadly variants mutating. If they are hoarding, those rich countries might come to deeply regret it.

We in the west continuously tout how generous we have been to the rest of the world. But our generosity has shown limits.

Africa, which is the furthest behind in its vaccine rollout having only fully vaccinated 3.6% of its 1.3 billion population, is set to be largely affected by the reduction in vaccine deliveries.

Vaccine equity is vital to end COVID-19 pandemic. As Global Citizen said,

“If everyone everywhere does not have access to a vaccine, the pandemic can only continue and millions of lives will remain at stake.” And those lives won’t only be in Africa. Vaccine equity is key to ending the COVID-19 pandemic. If everyone everywhere does not have access to a vaccine, the pandemic can only continue and millions of lives will remain at stake.”

Selfishness is dangerous when it comes to pandemics because by now we know that the longer the pandemic remains unchecked the longer the virus can mutate and the greater the chances that by natural selection the most dangerous virus will thrive. Again, when that happens the virus won’t just stay with the unvaccinated.

As the Guardian said in an editorial: “New variants—wherever they arise—are a threat to lives worldwide.” That is why delays in getting the vaccines to the developing world is such a dangerous thing and why selfishness is foolish. Forget about morality it is just not wise to favour ourselves too sharply. As the Guardian said, “Protecting others is the right thing to do. It is also the best way to protect ourselves.”

Recently, I thought it was time for some mathematics. My brilliant cousin and nuclear physicist, Erich Vogt, who unfortunately passed away a few years ago, once said that everything in the world can be explained by numbers/mathematics.  I am much too stupid to understand that, but I think it might be true. Apparently, that’s what you learned in his first year Physics class at the University of British Columbia. I think he learned that from Albert Einstein under whom he studied post graduate physics at Princeton University.

I thought of that recently when I considered some simple numbers. According to a recent study by the Center for Disease Control and Prevention in the United States (‘CDC’) in the United States, probably the world authority on Covid-19 and many other infectious diseases: Unvaccinated people are 11 times more likely to die from Covid-19 than vaccinated people. Compared to unvaccinated people, vaccinated people are nearly 5 times less likely to get infected, and 10 times less likely to get so sick from Covid-19 that they must be hospitalized.

The numbers are clear: Vaccines are effective protection against Covid-19. And very few people get sick from the vaccine. As the director of the CDC, Dr. Rochelle Walensky said, “As we have shown, in study after study, vaccination works.”

Is there really anyone needs to know anymore about why it is smart to get vaccinated? Aren’t numbers simple? Let’s keep it simple. Maybe they don’t tell us everything, like my cousin thought, but they sure do tell us a lot.