Vaccines and variants: COVID-19 Q&A with Toronto's top doctor
Published Thursday, June 17, 2021 7:18PM EDT
In her weekly segment with CP24, Dr. Eileen de Villa, Toronto's medical officer of health, answers viewer questions about COVID-19, including vaccines, variants and the latest public health measures.
CP24: How are you doing this week? It seems like there's encouraging news on the horizon.
De Villa: There's definitely encouraging news on the horizon. We've got some good weather. There's a vaccine out there, and people are getting the vaccine. So, we have some bright spots for sure.
CP24: The province added three more Delta hot spots. How concerned are you about the variant?
De Villa: I think we do need to be concerned about Delta. And you've probably heard me speak about this on a number of different occasions, and I certainly do try to raise it; we are watching what's happening in the United Kingdom. They are now seeing Delta as the predominant variant. That's happening there. And they are seeing more case activity as a result. We've seen them delay their reopening. They're not fully reopening, as per their original schedule. So, you see that certain Delta hotspots have been added. On the plus side, lots of vaccines coming in we hear from the province and lots of opportunities for people to get the vaccine. We've also seen that it makes a difference to have the vaccine onboard -- two doses of vaccine very effective against protecting against Delta variants. So, this is why it's so important for people to really get that vaccine. Get your first dose if you haven't had it yet. And then, as soon as you're eligible, get that second dose. Eligibility is certainly opening up over the next week or so. So, I would encourage people to take advantage of that.
CP24: With the accelerated timelines, how quickly can Toronto ramp up and be ready for the second dose-expansion?
De Villa: Let's start first with that demand for vaccines and the fact that there are lineups, which to me is a strong indication of demand. And that's really wonderful to see. It tells me that people appreciate and understand the real protective value that vaccines provide for themselves and everyone else around them. Now, we don't want people having to wait overnight. I don't think that that's something that's desirable for anybody, but we are happy to see the demand. And I can tell you that the vaccination partners all around the city of Toronto are certainly ramping up efforts, constantly speaking with each other as new information comes in and as we hear about vaccine supply. And we're constantly exchanging best practices on how we make the vaccination experience as good as it can be for everybody. And what that looks like is a little bit different for everybody. Some people prefer a mass immunization clinic. Others like pop-up or mobile clinics and find that actually more accessible to them. Whichever method of vaccine -- pharmacy, family doctor's office -- whatever makes the most sense for you and your circumstances, I would just encourage you please get vaccinated. We know that it is incredibly effective. And it's what we need to all participate in to get to the other side of this pandemic.
CP24: As more people become eligible for their second doses, they are confused and wondering what to do next, especially those who got the AstraZeneca as a first dose. The NACI updated its recommendation. They are now recommending an mRNA vaccine as a second dose for AstraZeneca recipients. What do you say to people who are watching this evolve and that science is changing on such a regular basis? How do you put their minds at ease?
De Villa: This is what I would say: to everyone who's gotten vaccinated and everyone who has two doses of a two-dose vaccine regime, thank you. Thank you for getting vaccinated. If you have two doses on board, you have a full vaccination course. This is the best thing each and every one of us can do over and above some self-protection measures. But certainly, getting fully vaccinated is the best thing we can do together in order to get us to the other side of this pandemic and to start to restore the activities we've missed for so long now. The NACI statement says, and I have not yet really delve into it myself, my understanding is that it does talk about how there are options available. They talk about a preference for an mRNA vaccine as the second dose if you received the first dose of AstraZeneca. But that there should be options available. That is a very viable option. So, I would just tell people, please go out get vaccinated --- get fully vaccinated. If it's a two-dose vaccine regime, you need two doses on board to be fully covered.
CP24: A viewer wants to know if a fully vaccinated person can still transmit COVID-19 to their friends and relatives who haven't had two shots.
De Villa: That will all depend on actually getting COVID. If you get COVID, let me say this; the vaccine is incredibly effective, but there's no such thing as 100 per cent. There is just no such thing as 100 per cent absolute protection. So, even with full coverage of the COVID vaccine, there is a chance that you may get a COVID infection, and therefore there is a chance that you can pass on that infection to other people. It is significantly reduced compared to somebody who has only one dose, or worse, is completely unvaccinated. But there is still a chance. That's why we're telling people, for now, the best thing to do is get vaccinated but continue to practice those measures of self-protection for the time being. Over time, we're hoping to be able to change that. I know our provincial and federal counterparts are working on that advice but do stay tuned.
CP24: A viewer asks, what's the new guidance for new parents regarding newborns and visitors in terms of allowing family from fully vaccinated households to visit our newborn? Can they hold the baby? Do they need to wear masks? What about single-dose households?
De Villa: You've heard me talk about getting fully vaccinated. This is certainly a very important step for each and every one of us to participate in at the same time. Right now, the guidance is to continue to practice some self-protection measures, especially when we're talking about interacting with people outside of your direct household. So, for now, I would really encourage people to be cautious. With your newborns, you're going to want to make sure that you're only really interacting with people who are fully vaccinated. And even then, for now, there's nothing wrong with a little extra layer of caution. We are all still very much in the learning phase, and with newborns, I can appreciate why parents might want to use that a little extra caution in respect of protecting their newborns who have really just developing immune systems. So having a little extra caution, I think, is quite appropriate and a very reasonable thing to do.
CP24: A viewer says many residents in the Kitchener-Waterloo region do not believe in getting the vaccine. They want to know what is being done to educate people who are hesitant about vaccines. They ask, how can we be reassured that when we reach other phases of reopening and start gathering, we won't be gathering with unvaccinated people at work or church?
De Villa: While I can't speak specifically to what's happening in the Kitchener Waterloo area, we certainly know that there is increased activity and it is one of the Delta hotspots that's been identified by the province. I would also say this and you'll have heard me say this before; I think it's actually reasonable for people to have questions around vaccines and around their health and treatments that are being recommended for them. And I think that what needs to happen in these circumstances is actually having conversations. What is the nature of the concerns? How might we be able to address them? I think having an honest, candid conversation around what the fears or concerns are around vaccines is the first step towards addressing that hesitancy. Ideally, this should happen with somebody you trust and somebody knowledgeable about the vaccines and the science behind vaccines. So, for some people, that means maybe their primary care provider. For others that may be calling the local public health unit. Most of us around the province have information either on our website or available through a hotline. It may be through a trusted family member who actually has some information about vaccines, getting that from reliable sources, whether it's the Public Health Ontario, your local public health unit, or the Public Health Agency of Canada. There are some very reliable sources out there. But I would just encourage, have the conversation. That's why I ask everybody who's already had their vaccine and is well on their way to getting that protection, talk to the people in your community. Talk to the people in your circle. Tell them about your experience and really encourage them to get the vaccine for themselves and the rest of us.
CP24: A viewer who lives in a downtown condo building says one of the concierges has said that he does not want to get vaccinated. He does not wear a mask while on the desk, and there is no shield at the front desk. Is it a requirement for him to be vaccinated to keep his job?
De Villa: There are no specific requirements around vaccination. Right now, vaccination isn't mandatory for anyone in particular. It is, of course, strongly encouraged for all of us. It seems to me that this is one of those situations where again having a real, honest, candid conversation around his vaccine concerns. And providing some information and really trying to help them see their way through to get the vaccination, I think, is one of the steps that can be taken in this circumstance. The more of us that get vaccinated, the better protected we are as a community. And frankly, the sooner we can restore life, more like it was before there was a COVID-19. And I know we are all so eager to get there. So, vaccination is absolutely part of getting us there sooner so that we can enjoy all those things that we've missed so much over the past several months.
CP24: A viewer wants to know why the U.S. is not accepting the AstraZeneca vaccine when you want to enter their country. He asks, does this mean I have to get a double vaccination of one of the other vaccines to visit there in the near future? Several U.S. shows have indicated that they will only accept people fully immunized with FDA-approved vaccines. AstraZeneca is not approved for use south of the border.
De Villa: This is one of those emerging issues that's coming up. The story of COVID has been a constant learning and all these emerging issues coming out. I can't speak very specifically to what the United States government had in mind, but my understanding of it is that at this point in time, the AstraZeneca vaccine isn't licensed for use in the United States, and so they have a different perspective around the vaccine itself. And that may be weighing into their decision around whether people can travel into the United States. I think each country sets its own rules around what the expectations are. What will be required, therefore, and what will be expected of visitors to the United States in terms of proof of vaccination, and which vaccines will they consider, I think that's best directed towards the United States government authorities. And I think they'll be able to answer those questions, but I do expect that there will be a little bit of this bumpiness if we can call it that, as we're all climatizing and getting used to this new world with vaccination and understanding more fulsomely how our different rules in vaccination programs work with each other. So, I wish I had more specific stuff for you. I don't at this point, but I'm sure that the U.S. will be putting out more information for visitors to their country sooner rather than later.
CP24: A viewer says stadiums in Europe are full of people watching soccer. At what point could we see similarly large outdoor gatherings in Toronto, the viewer asks.
De Villa: This is chalked up to the differences that different nations have and the different approaches they have regarding regulations. What can I tell you about what the future looks like here? It's actually all spelled out under the provincial roadmap to reopening. And the viewer may recall that last Friday, we moved into step one of the provincial path towards reopening and that's why we're seeing more availability of outdoor dining and just a little more flexibility in terms of what's open to us including retail. As we move through each step, more vaccinations on board in the population, declining hospitalizations, and all indicators around COVID-19 improving, the province says that they will move us through the different steps of the roadmap to reopening so that eventually we will be at a point some weeks down the road where that kind of activity hopefully will be happening here. Of course, this all depends on us making sure that we're getting vaccinated and seeing the continued improvement in COVID-19. So just a little note of caution, we started at the beginning of this segment around a Delta variant and its impact on the United Kingdom. We've seen other areas of the province now being identified as delta hotspots. Toronto is one of those. So, we really want to make sure that we're doing our very best to get vaccination up, to keep transmission down, which means just being careful for now—taking it cautiously so that we don't see huge resurgences and COVID-19. That's what will get us sooner to the kind of activity that the viewer is talking about.
CP24: Last month, we see some fans in seats for the Leafs playoff game. Do you think we can see a similar situation for Blue Jays, Argos, TFC games this season? How possible is it?
De Villa: We are all hoping that that's a possibility later on in the season. And really, a lot of this is in our hands. You'll hear me say this over and over again. What we do together as a community is what controls what happens in our future. The more we take up vaccine, the more we are able to be careful now in order to do keep transmission rates low while vaccination rates are going up, the sooner we will be able to get on with those aspects of life, all those activities that we've missed so much over the past several months. So, I do encourage each of us to stay vigilant, to really stick to the self-protection measures, for now, to get vaccinated as soon as possible. And that's really the best we can do to get us to that point where we can start to enjoy group activities like baseball games and the like.
CP24: A viewer wants to know whether there will be a different framework for vaccinated people versus unvaccinated people? The viewer says it is unfair that vaccinated people have to miss out on a normal life because of anti-vaxxers.
De Villa: I think there will definitely be different advice. That's the kind of conversation that I know I've been participating in with provincial counterparts. There will certainly be different guidance provided because there are different circumstances. So, again, I can't emphasize enough how important it is for people to get vaccinated to have those conversations. It will play a major role in us getting our lives back.
CP24: What should we be looking out for in the coming weeks?
De Villa: I think we want to see those continued declines happening in all the COVID indicators and we want to see vaccinations going up. Toronto is in the midst of a youth vaccine blitz week. We would love to see those 12 to 17 get their vaccines. We would love to see more people get first doses and get their second doses as well. This is a key step to us getting to the other side of this pandemic.