Author: Ernie Dainow

On April 16, 2021 Ontario extended its stay-at-home order, banned outdoor gatherings with people outside their household and shut down outdoor amenities like playgrounds, tennis and golf. It also stepped up enforcement powers for police in a bid to stem the exponential rise in Covid-19 cases. But it didn’t institute paid sick days for essential workers.

These measures are not based on science and do not make sense to most people. How many cases were there of Covid being transmitted at a playground?

A day later Ford reversed the decision to close playgrounds.

Here is the assessment from Ontario’s Covid-19 Science Advisory Table: “Without stronger system-level measures and immediate support for essential workers and high-risk communities, high case rates will persist through the summer.”

https://www.cbc.ca/news/canada/toronto/covid-19-ontario-april-16-2021-new-restrictions-modelling-1.5990092

Finally, doctors are speaking out more forcefully. It remains to be seen if this has any impact on these policies.
https://www.cbc.ca/player/play/1886237251529

“The root cause is the fact that the people in my ICU right now, who are essential workers or related to them, do not have adequate protection from the virus. The modelling was very clear.” (Dr. Michael Warner, Head of critical care at Michael Garron Hospital)

It’s worth listening to Rosemary Barton’s comments about Doug Ford. She is the CBC’s chief political correspondent, an astute observer of Canadian politics. It is obvious from what she says and her tone that she thinks that Ford skirting the truth and making the pandemic political is pretty despicable.
https://www.cbc.ca/player/play/1886559299598

Glaringly absent from the emergency measures to reduce the spread of Covid are restrictions on workplaces. The Workplace Safety and Insurance Board data indicated that more than 20,000 confirmed workplace cases of Covid -19 have been reported. Just since March 1, 2021, ministry inspectors have conducted 1,800 Covid -19-related field visits in the construction sector, issued over 3,770 orders on those visits and stopped unsafe work 11 times.
https://canada.constructconnect.com/dcn/news/government/2021/04/breaking-ford-announces-closing-of-non-essential-construction

The one workplace restriction brought in by Ford was to shut down some non-essential construction such as shopping malls and large office buildings. Note that this does not include the huge residential construction industry. So in a choice between increasing infections, hospitalizations and deaths or a 4-6 week delay in people being able to move into a new home, why did Ford pick increasing deaths? A delay in construction means losses of millions of dollars to developers.

The list of businesses that the province deems as “essential” is a really long list. See the bottom of the page in https://toronto.ctvnews.ca/ontario-orders-all-non-essential-businesses-to-shut-down-1.4864492

In response to a question from a reporter about closing more workplaces where we know transmission is occurring, Ford rejected it outright, saying that there is a “very deep supply chain” and many industries supply materials which are needed by essential services. He gave as an example that you cannot shut down the forestry industry because it supplies an important ingredient that is needed to make Aspirin.

It does not seem that any analysis has been made into this option. I’m sure that the pharmaceutical industry has enough inventory so that shutting down forestry for 4-6 weeks would not result in a shortage of Aspirin on pharmacy shelves. The same conclusion could be arrived at for many other “essential” services.

Using Ford criteria, a factory that makes paper clips could claim it was essential, because it supplies a product that is used in hospitals.

This makes it pretty clear that the fundamental problem with Doug Ford is that he is beholden to business interests. He needs their support to get re-elected. Even faced with a dire health situation and recommendations from many doctors and scientists, Doug Ford sacrifices public health for his own political interests.

Hopefully, enough people in Ontario will come to recognize this and never elect him for anything ever again.

At the end of March, about 30% of seniors aged 80 and up in Ontario had not received their shot. This was regarded as very low and a failure of the vaccine rollout. Many reasons were suggested for this.

https://www.cbc.ca/news/canada/toronto/covid-19-vaccine-ontario-booking-appointments-1.5958792

However, the article does not mention what has been one of the main problems. Many people just did not know how or where to get a vaccination. Often when a vaccination site opened up, it was word of mouth that notified people that they could register for a shot. I registered for my shot when I got an email from a friend at 11 pm one night. Of course, this leaves out many people who aren’t as well connected.

Many older people who got a vaccination were able to do so because they had a relative or a friend who negotiated the myriad paths to find out how to book a shot. Even computer literate younger relatives often spent hours scouring websites to locate a vaccination site that their relative/friend could use. I have heard these stories from many people. This has been a problem from New York to California as well as Ontario. 

Why has the vaccine rollout been so chaotic?

There is really no excuse for yet another case of really bad pandemic policy and management by government and public health.

Here’s a simple common sense approach that should have been followed (this example is for Ontario but is applicable to other jurisdictions).

Every person eligible for a vaccination in Ontario has an OHIP number (Ontario Health Insurance Program). The government has a database of all of these people. Each OHIP record has the name of the person, date of birth, address and phone number. So the Ministry of Health could have easily contacted every person in Ontario to give them clear instructions in advance on how to get a vaccination. 

Here is a simple letter that should have been sent out in November to everyone in Ontario with an OHIP number.

That was pretty easy, it took about 20 minutes to draft this letter.

You’d think that with a budget exceeding $1 billion for a provincewide vaccination plan, someone in the Ontario government could have organized this. Of course this plan would have to be followed up with a robust web server and phone answering service built to handle a large number of requests. In 2020, this was not rocket science.

Ontario did finally provide a central website for booking vaccines, but instead of in November it was not up and running until March 15.

As the number of variants of concern increase to 50% of all cases in many areas and Covid-19 case counts start to move up, there is increasing concern that we are at the start of a third wave in Canada and the U.S. In spite of these warning signals, governments continue to relax restrictions, which threaten to accelerate this trend. Many parts of Europe are already in the midst of a major third wave.
https://www.cnn.com/2021/03/19/europe/coronavirus-europe-third-wave-intl/index.html

Because the variants spread more rapidly than the normal Covid-19 virus, the  third wave can occur extremely quickly. This chart shows the rapid rise in the United Kingdom due to the UK variant that peaked in January and in Italy the sharp increase that has doubled the number of daily new cases  in three weeks.

This chart can be accessed with the following link where you can add other countries for comparison and follow the progress of the third wave as time goes on.
https://tinyurl.com/tw6pdb7a

Where is Canada headed?

In December a researcher at the B.C. Centre for Disease Control was reviewing the clinical trial data of the Pfizer vaccine and recalculated the efficacy of the first dose at 92% rather than 52% that Pfizer  had reported. She realized that with such a highly protective first dose, the benefits derived from a scarce supply of vaccine could be maximized by deferring second doses. This was reviewed by the National Advisory Committee on Immunization (NACI) and on March 1 they issued a strong recommendation that the second dose of all COVID-19 vaccines should be delayed up to four months after the first. All the provinces are following this recommendation.
https://www.cbc.ca/news/health/canada-covid-19-vaccine-delay-risk-1.5939134

This was an insightful and bold action taken by Canada. No other country has delayed second doses for 4 months. This almost doubles the vaccine supply in the country.

In addition, after various delays in vaccine deliveries there is a big increase in confirmed deliveries which will double the number of vaccines in Canada in two weeks.

These two changes in Canada’s vaccine rollout make a huge difference. The revised coronavirus model now shows a manageable third wave peak of less than 7,500 new cases daily. By May, the population immunity is about 40% and the number of new cases start to decline. Since Canada sustained daily cases of 10,000 in January 2021, this situation would not trigger a lockdown.

However, while the vaccination rate is increasing, more regions are relaxing restrictions. If the reproduction number increases by only 20%, the third wave peaks at 15,000 daily cases. This would probably trigger lockdowns in some areas of the country in mid-May.

In the second wave, most regions, especially Ontario and Quebec, delayed too long to bring in lockdown measures. If they had done this at the beginning of the second wave in November instead of delaying until the last moment in December, the lockdown period would have been shorter and the population could have enjoyed a December holiday season closer to “normal”.

The variant infection wave accelerated really quickly as shown on the charts for the UK and Italy. This characteristic delay to act by provincial premiers and their health ministries portend a bad outcome. So it’s no wonder that health experts do not trust that their own governments will handle the third wave very well. Sunnybrook, one of the largest hospitals in Ontario,  is building a field hospital in preparation for a possible third wave. This is being done with federal funds provided for such a purpose. The Ontario minister of health had no comment on this development.
https://globalnews.ca/video/7689345/coronavirus-sunnybrook-field-hospital-pops-up-amid-concerns-of-3rd-wave

Regardless of whether there is a third wave or not, here are some of the risks associated with the new variants.

Where is the U.S. headed?

The U.S. continues to increase its vaccination rate. The current trend will easily outpace the variants with no significant third wave. By May the population immunity is 50% and cases decline rapidly. 

However, this scenario is not likely. Already many states have removed all restrictions. If the reproduction number increases by 35%, the U.S. will have a third wave and daily new cases will increase to 185,000. In the U.S. there was a peak of 250,000 cases a day in January 2021. Only some areas particularly hard hit by a third wave would likely implement lockdowns.

This is a lot of cases and corresponding deaths, but the U.S. is able to sustain a high case and death count without resorting to tough lockdowns. This is distinctly different from Canada where cultural and political differences enable public health science to exert a stronger influence over business interests in determining lockdown policies. 

The Oxford-AstraZeneca vaccine for Covid-19 was first approved and used in the UK at the beginning of December. Since then it has been used in many more countries. 

On February 26, 2021, Health Canada authorized the AstraZeneca COVID-19 vaccine for use in adults 18 years of age and older.

However, on March 1, 2021, the National Advisory Committee on Immunization (NACI) recommended the use of the AstraZeneca vaccine be limited to individuals between the ages of 18 and 64, based on AstraZeneca’s clinical trial data.

On March 16, NACI reviewed more recent real-world effectiveness studies and expanded its recommendation for the use of the AstraZeneca vaccine to people 65 years of age and over.

NACI makes recommendations for the use of vaccines currently or newly approved for use. It is up to each province to tailor their own vaccination rollout plans.
https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci.html

Quebec did not restrict the use of the AstraZeneca vaccine for seniors.

BC approved the use of the AstraZeneca vaccine for workers at risk. 

Ontario decided it would not administer the AstraZeneca vaccine to seniors. Instead, it opened up vaccination reservations for people 60-64 who would get the AstraZeneca vaccine. This caused a lot of confusion, resentment and went against its own policy. 

Ontario’s policy for the Phase 1 vaccine rollout includes only the following people:
– Congregate living for seniors
– Health care workers
– Adults in First Nations, Métis and Inuit populations
– Adult chronic home care recipients
– Adults over 80 years old
https://covid-19.ontario.ca/ontarios-covid-19-vaccination-plan

The AstraZeneca vaccine should have been allocated to these other groups so that the high risk seniors over 80 years were not bypassed by a younger age group. 

This is just another example of bad vaccine management by Ontario. It won’t be the last.

________________

In the meantime, on March 7, Austria reported two cases of blood clots in people who had received vaccines, one of whom died.

On March 11, Denmark suspended all use of the AstraZeneca vaccine after several cases of blood clots were reported.

By March 16 there were 18 countries in Europe who had suspended the AstraZeneca vaccine, pending an investigation. 

All adverse events for any drug, not just vaccines, are reported to a central regulatory agency for review. In the U.S. this is the FDA, in Europe it is the European Medicines Agency (EMA). The regulator then does a thorough investigation and issues an advisory.

The EMA investigated the 25 cases of blood clots that occurred in 25 million people. On March 18, 2021 it issued its report, concluding that “benefits still outweigh the risks despite a possible link to rare blood clots”. https://www.ema.europa.eu/en/news/covid-19-vaccine-astrazeneca-benefits-still-outweigh-risks-despite-possible-link-rare-blood-clots

One of the things that was investigated is the batch of the vaccine to make sure that there was not a fault in the manufacturing of the vaccine. Other factors were investigated and when no causal link was found then the conclusion is that the variation is just a random fluctuation, since people can experience blood clots for many other reasons that are not at all related to the vaccine.

To understand random fluctuation, let’s do some coin tosses. A coin that is balanced and not weighted to any side will come up H (heads) half the time and T (Tails) half the time.

Here are a few sequences.

If you saw this sequence, would you think it was likely?

H T H T H T H T H T H T H T H T H T H T ………… 10/20 Heads, 10/20 Tails

The answer is No. This is a repeating sequence of the exact probabilities, Heads followed by Tails. In a random sequence, it is very unlikely for there to be regular repeating patterns. 

There is much more likely to be random patterns, like

H T T H T T T T H H H H T H T T T T T H ………… 8/20 Heads, 12/20 Tails

So how do you determine if 25 blood clots in 25 million people is just a random sequence or if it signifies that there is something systematic, a non-random reason for the variation?

The answer is probability and statistics, a branch of mathematics that has been used for centuries to answer questions like this.

According to such mathematical analysis, 25 blood clots in 25 million people is not significant, in other words it is most likely just normal random fluctuation.

A million is a number that gets bandied around a lot but few people have an intuitive sense of how big this number is. Who has ever counted to 1,000,000 or ever even seen 1,000,000 things with their own eyes.?

Here is a visual picture. The area of the red dot compared to the whole grey area represents roughly 100 out of a million. Computer screen resolution does not allow a smaller dot to represent only 1 out of a million, you would barely be able to see it. This picture is 100 times more than the blood clots that were reported from people who took the AstraZeneca vaccine.

Should you get the AstraZeneca vaccine?

These changing conclusions have led some people to decide that they would not get this vaccine. This is really not a wise decision. All concerns about the AstraZeneca vaccine have been thoroughly investigated by scientific experts in the field. Deciding that the vaccine is not safe when the conclusion by the EMA that the vaccine is safe is an irrational response that ignores all science. 

Unless you know for sure that if you turn down an AstraZeneca vaccine you will be able to get one of the other vaccines within a week, you are putting yourself at great risk. With the variants surging, the probability that you could get Covid may be as much as 1 in 500 each week. If you get the AstraZeneca vaccine, which has an efficacy of 76% after the first dose, your risk of getting Covid is not only significantly lower, but your infection would be a lot less severe. And your risk of getting a blood clot from the vaccine is practically 0.
https://www.astrazeneca.com/media-centre/press-releases/2021/covid-19-vaccine-astrazeneca-confirms-protection-against-severe-disease-hospitalisation-and-death-in-the-primary-analysis-of-phase-iii-trials.html

Ever since the first lockdowns were imposed to try to slow down and control the exponential spread of Covid-19 were imposed in March 2020, there have been many counter arguments and objections. The general argument is that lockdowns are extremely expensive not only in terms of the economy but also because of other deleterious effects on health, education and general social welfare and that therefore lockdowns are an overreaction. 

Cost/Benefit analyses have claimed to show that the cost of lockdowns is far greater than the benefits. The problem in most of these comparisons is that they use numbers for Covid cases and deaths that are after lockdown, since most countries have imposed lockdowns. This comparison needs to be done against the Covid cases and deaths that would have occurred if there had not been a lockdown.

To do this comparison, here is a spreadsheet that shows the difference between lockdown and no lockdown. It is based on actual Covid case numbers (shown in blue) from the time lockdown was imposed in Canada.

The first block (in green) shows how cases would have grown with No Social Distancing measures.

R(t) is the reproduction number, the average number of people that are infected by someone who has the virus.

On Mar 22,
New Cases are 2.8 * 188 = 526
Total Cases rise to 526 + 252 = 778
And so on for each week. That’s all there is to this spreadsheet, pretty simple math.

Under Lockdown (pink block), R(t) reduces from 2.8 to 0.9 in May.
For a simple model, this matches the Actual data (yellow block) pretty well.

The difference between Lockdown and No Social Distancing is pretty dramatic.
On May 17 there are over 3,093,570 Total Cases of Covid if nothing is done, but only 74,100 with lockdown.

Note that Lockdown is the only social distancing measure that will reduce an R(t) of 2.8 to less than 1, which is necessary to slow the exponential growth.
https://wwwnc.cdc.gov/eid/article/27/2/20-3412-f5

You can see why so many countries went into Lockdown in March 2020. If you were a leader of a country and your health experts showed you these projections, even if you didn’t understand the math and weren’t sure of the result, would you have risked 3,000,000 cases of Covid that would have completely overwhelmed the hospitals versus 74,000 cases by not calling for a Lockdown? Most responsible leaders did not take that risk, with a few exceptions like Bolsonaro in Brazil and several U.S. state governors like DeSantis in Florida.

Another argument against Lockdown uses Covid statistics and excess mortality graphs to show that Covid-19 is no worse than a bad flu season. We don’t impose lockdown for flu, why do it for Covid?

Again, these arguments use existing Covid statistics, not what would have happened if there had been no lockdown.

Let’s look at the numbers.
A bad flu like H1N1 (Swine flu 2009) had an R(t) of 1.4. Here is the spreadsheet.

So Covid is a lot worse than a bad flu. After 9 weeks there are over 3,000,000 Covid cases versus 13,000 flu cases. Again, this is simple high school math.

References

Actual weekly case data (blue)
https://ourworldindata.org/coronavirus-data-explorer?zoomToSelection=true&minPopulationFilter=1000000&time=2020-03-02..latest&country=~CAN&region=World&casesMetric=true&interval=weekly&smoothing=0&pickerMetric=location&pickerSort=asc

Reproduction number for Canada
https://globalnews.ca/news/6917781/coronavirus-reproduction-number-canada/

Reproduction number for H1N1 Flu
https://www.livescience.com/covid-19-pandemic-vs-swine-flu.html

Virus variant headlines have been superseded by excitement about new vaccines being approved.

• In Canada, AstraZenica was approved and Johnson & Johnson approval is expected within weeks.
• In the U.S. the Johnson & Johnson vaccine was approved and started rolling out on March 1, 2021.

Will these new vaccines be enough to change the trajectory of the virus variants?

I updated the Canada model to add new vaccines not already included under the existing contracts.

• 2 million doses of AstraZenica from March to end of May.
• 10 million doses of Johnson & Johnson from June to end of September. 

This increase in vaccinations will not be enough to prevent a huge spike in Covid-19 cases from the virus variants, and a lockdown will need to be imposed by the end of March.

In the U.S. the situation is quite different. Not only have they vaccinated a lot more of their population but they have also had many more Covid-19 cases which impart immunity. The U.S. immunity as of March 1 is approximately 25% of the population compared to 7% in Canada. As a result, the U.S. does not face a huge spike from the virus variants.

For a complete graph of daily new Covid-19 cases in Canada and the U.S. see
https://ourworldindata.org/coronavirus-data-explorer?zoomToSelection=true&time=2020-03-01..latest&country=CAN~USA&region=World&casesMetric=true&interval=smoothed&smoothing=7&pickerMetric=location&pickerSort=asc

There are many variables at play here, and these scenarios are quite sensitive — a small change in one of the variables can make a big change in the result. There is no question that there is a race between the virus variants and the vaccines. The very different case predictions between Canada and the U.S. shows how critical the immunization level (total of vaccinations and prior cases) is at the time the virus variants start to increase in mid March.

The news has been full with reports of the coronavirus variants. These are several new versions of Covid-19 that have developed through mutation. In fact there have been many mutations of Covid-19 since it was first discovered. Here is a report of six strains from August 2020. https://www.sciencedaily.com/releases/2020/08/200803105246.htm

But more recently several new variants have appeared with changes in the spikes on their surface which helps them attach more easily to human cells than the original virus. These are the new variants of concern that have been identified in Canada.

UK Variant B.1.1.7 first emerged in the U.K. in September 2020. This variant spreads about 50% faster than the original strain and can be transmitted in less time.

South Africa Variant B.1.351 was first discovered in South Africa in December 2020. This variant is more efficient than others in targeting and infecting healthy cells. South Africa paused the rollout of the AstraZeneca vaccine after preliminary trial data showed it offered minimal protection against mild to moderate illness from this variant. 

Brazil Variant B.1.1.28 or P.1 was first identified in December 2020 when it caused one of the deadliest outbreaks in Manaus, Brazil. This variant may reduce the ability of antibodies developed from previous infections and vaccinations from killing the virus.

https://www.scientificamerican.com/article/the-most-worrying-mutations-in-five-emerging-coronavirus-variants/

Here are reports that show the rapid spread of the UK variant, in Ireland and Denmark.

• In Ireland less than 10% of positive tests at Christmas were caused by the UK variant, but rose to 45% by the middle of January.
• In Denmark the UK variant climbed from 0.3% of all samples sequenced in November to 2.9% in early January. The variant’s share of total cases is growing exponentially and is expected to be the dominant variant by mid-February. Denmark has been in lockdown since Dec. 11 and case numbers are dropping. The reproduction number is now at 0.9 but that is not particularly reassuring. “We think this is like the calm before the storm. We need to have a reproduction number below 0.7 if we want to avoid exponential growth in February and March.”
  https://www.spiegel.de/international/world/can-germany-stop-the-new-supervirus-a-e9ffc207-0015-4330-8361-b306f6053e15
   (Der Spiegel is the largest weekly news magazine in Europe)

This chart shows the percentage of all cases that are the UK variant in countries where it has been detected.

https://tomaspueyo.substack.com/p/variants-v-vaccines

The UK variant is the most prominent variant in Canada, with almost 400 identified as of February 11.
https://nationalpost.com/news/canada/the-state-of-covid-19-variants-in-canada-ontario-has-more-than-half-the-cases

On January 8, a single case of Covid-19 was detected at Roberta House, a long-term care home in Barrie, Ontario. The disease ripped through the facility with such speed that by January 25 more than 200 people had contracted the virus and 44 residents and one caregiver had died. The variant was also detected at another long-term care home in the area.
https://barrie.ctvnews.ca/more-than-100-cases-believed-to-be-u-k-covid-19-variant-linked-to-barrie-ont-care-home-1.5282898

Note that the UK variant spreads more quickly, estimated at 50%, but it is not currently known to be more virulent. That is, you are not more likely to die if you get the UK variant. It may be counter-intuitive but a virus that is more contagious will cause a lot more deaths than a virus that is deadlier, as shown in this graph.

The math for this is quite simple:

Suppose 10,000 people are infected, R=1.1, infection fatality risk=.8%, generation time=6 days. 

In a month there are 5 periods of 6 days, so transmission increases by 1.1⁵.
So 10,000 x 1.1^5 x 0.8% = 129 new fatalities after a month of spread.

If the fatality risk increases by 50%,
10,000 x 1.1^5 x (0.8% x 1.5) = 193 new fatalities.

But if transmissibility increases by 50%,
10,000 x (1.1 x 1.5)^5 x 0.8% = 978 new fatalities.

(You can verify the numeric result of a formula by copying and pasting it into a Google search bar, which can be used as a general calculator.)

So what are the implications of these new variants?

Since they are more transmissible, you should take extra precautions when you are in the vicinity of other people.

• Make sure to follow the social distancing rules, which have not changed from 2 meters ( 6 feet). 
• Try to reduce the time that you are in proximity to others.
• There is a new recommendation from the CDC to wear double masks. They can increase your protection from aerosol droplets by 90%.
  https://www.theguardian.com/world/2021/feb/10/mask-guidance-cdc-two-masks-close-fitting

Aside from a “third wave” spike in cases in March or April, there is not a lot being said about the full impact on the pandemic in Canada. While many epidemiologists have access to models that make predictions, I have not seen any graphs of them. Health authorities are pussy-footing around this, much as they did at the beginning of the pandemic in March 2020. 

Is it because the picture looks very grim?

This graph shows the pace of the UK variant in the United Kingdom. It peaked over a period of 2 months and increased the daily cases by a factor of 4. The UK entered lockdown on January 5, 2021, after which cases have declined.

https://ourworldindata.org/coronavirus-data-explorer?zoomToSelection=true&minPopulationFilter=1000000&time=2020-03-02..latest&country=CAN~GBR&region=World&casesMetric=true&interval=smoothed&smoothing=7&pickerMetric=location&pickerSort=asc

To see how a similar pattern would look in Canada, I returned to the spreadsheet model I used at the beginning of the pandemic. I “restarted” the model by entering the actual case counts for February 13, 2021 and modified the spreadsheet calculations to model the following assumptions.

– Used the Reproduction number R(t) of 1.1 reducing to .9 for lockdown periods.
https://epiforecasts.io/covid/posts/global/
– In March to April gradually Increased R(t) up to 50% to account for the increase in the UK variant.
– Added actual vaccinations that have been administered.
– Added the vaccine rollout assuming Canada hits its target that “everyone who wants a vaccination will get it by September 2021”. Since not everyone will want the vaccine, 70% of the population was used.
https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/prevention-risks/covid-19-vaccine-treatment/vaccine-rollout.html#a4a

Here is the result, using relaxed lockdowns starting in February to reflect the fact that Ontario, Quebec, Alberta and Manitoba (but not B.C.) have begun easing restrictions.

This shows a large spike over a three month period with an increase of 4 times the number of daily cases, reaching almost 30,000 cases per day at the end of May before the vaccines start to take effect. This is very similar to what happened in the U.K.

This large increase in daily cases means that there will have to be another lockdown. 

Here is the result when a lockdown is applied for 7 weeks beginning mid-April.

This shows that by the end of the lockdown in mid-May when the percent of the population that is vaccinated reaches 33%, the number of cases stops increasing. By the end of August there are less than 100 cases per day and the percentage of the population that has been immunized (through vaccination or prior infection) is 70%. This is herd immunity. 

Life could return to normal within Canada in September 2021.

Here’s a summary of some of the things that were predicted in blog postings this year.

Vaccine rollout

On November 15th, in a section titled Vaccine News, it was predicted that it will likely take at least 10 months to vaccinate enough of the population to reach an immunity level that will slow the spread of Covid-19, assuming that all the challenging logistics of distributing and vaccinating millions of people can be managed without major delays. Given the track record of public health with the coronavirus this does not seem likely.
https://www.nytimes.com/2020/11/14/health/covid-vaccine-distribution-plans.html

The post on December 17th provided more detail to explain why the vaccine rollout in both the U.S. and Canada was not likely to meet the announced dates. In the last few weeks this story has become headline news almost every day.
https://anydaynow.blog/vaccine-rollout-confusion/

The U.S. had announced a plan to vaccinate 20 million Americans by the end of December. Only 15% of this goal was achieved.

In Canada, despite declarations by several provincial premiers that the federal government was not delivering enough vaccines, the actual statistics show that inoculations have lagged way behind the delivery of vaccines.
https://covid19tracker.ca/vaccinegap.html

Operation Warp Speed in the U.S. declared that they would vaccinate everyone by June 2021. In Canada, Trudeau promised that all Canadians would be vaccinated by September 2021.

The December 17 post called these targets overly optimistic and repeated the prediction made on Aug 15, 2020 that enough of the population (less than 100%) will be vaccinated to achieve herd immunity by the end of October 2021.
https://anydaynow.blog/vaccines-on-the-way-in-2021/

On Dec 31, 2020 Dr. Fauci said that the U.S. could return to normal life by early fall.
https://abc17news.com/news/health-news/2020/12/31/fauci-says-us-can-return-to-normal-by-fall-if-it-puts-aside-slow-start-and-is-diligent-about-vaccinations/

Who is more believable, Warp Speed and Trudeau or Dr. Fauci and this blog?

There was great excitement this week as the first Covid-19 vaccines were delivered. However, along with it has been great confusion. 

Although many reports have cautioned that there is still some way to go before reaching the end of the pandemic, they are not giving a clear indication of when that will be or why. As a consequence, many people think it will be quite soon and they don’t have to be that diligent about taking precautions and following coronavirus health guidelines. This is partly due to irresponsible reporting where journalists are not asking the right questions to explain the whole picture. It is also due to the poor planning of public health who have not made it clear how and when people will be getting vaccinated. Yet another example of how they are scrambling at every step of this public health crisis.

In the U.S., Operation Warp Speed has engaged the military to deliver the vaccine. They declared that they will have enough vaccines for everyone in the US by April 2021.
https://www.reuters.com/article/health-coronavirus-usa-immunization/explainer-when-will-covid-19-vaccines-be-generally-available-in-the-united-states-idUKL1N2H713H

More recently they changed their estimate to be more in line with the CDC who estimate June 2021. Since the vaccines required two inoculations this means that 700 inoculations need to be performed. It does not seem realistic that this can be done in six months. Warp Speed has the responsibility to deliver the vaccines from a few pharmaceutical companies manufacturing locations to a limited number of depots in the US. They may be able to deliver 700 doses. However, that is not the end of the job. A much larger part of the job and a bigger challenge is to get those vaccines from the depots and deliver them and inoculate people. The Trump administration allocated billions of dollars for Warp Speed but hardly any money for local public health to do the vaccinations. According to them this is a state responsibility. But most states do not have the funds in order to be able to do this.
https://www.cbsnews.com/video/funding-shortfalls-hinder-vaccine-distribution-in-small-towns

It is likely that Congress will pass a bill to provide some vaccination funding for the states. But this late in the day means that many states have not done the necessary planning.

In Canada there are the same questions. The military has also been enlisted to organize the logistics of the vaccine rollout. But they only know the initial part of the rollout which is getting the drugs from the manufacturer and delivering them to a limited number of distribution points across the country. After that the local provincial health departments need to figure out how they are going to vaccinate millions of people. Here is an interview with the CEO of the University Health Network, one of the two vaccination centers in Ontario, which reveals that a lot of basic questions remain unanswered.

In spite of all this uncertainty, the Trudeau government has stated that all Canadians who want to be immunized will be vaccinated by September 2021.
https://www.ctvnews.ca/health/coronavirus/canada-plans-to-vaccinate-everyone-who-wants-it-by-the-end-of-2021-1.5224265

I think this target is overly opimistimc. I am sticking to the prediction made in the blog on Aug 15, 2020 that enough of the population will be vaccinated to achieve herd immunity by November 2021.

We don’t need to vaccinate everyone to halt the exponential rise of new cases. We only need about 60% immunity in the population. At that point Covid-19 will not disappear but the number of new cases will decline to a manageable level and large outbreaks will not occur. This also means that if as many as 40% of people choose not to get the vaccine, it does not prevent us from achieving herd immunity and controlling the pandemic.

There really is no excuse for this lack of planning. It has been known for at least six months that Pfizer and Moderna would be submitting their clinical trial data to the FDA at the end of December, and that with fast track FDA approval, vaccines would be ready for rollout in January. Public health had six months to prepare plans for local distribution but in both the U.S. and Canada they seem to be scrambling.

By contrast, here are some of the plans the U.K. has in place.
https://www.theguardian.com/world/2020/nov/11/thousands-of-hospital-staff-to-be-deployed-in-covid-vaccine-rollout

https://www.theguardian.com/world/2020/nov/20/nhs-prepares-dozens-of-covid-mass-vaccination-centres-around-england