The TRIPS Waiver -- In The Round

"Back in March, the president of Tanzania, John Magufuli, died, very likely due to complications from COVID-19. Ironically, the autocratic ruler of the east African nation had been a staunch COVID-19 denier, refusing to vaccinate his country’s population and instead recommending traditional cures and prayer."

"Tanzania is by no means a basket case, nor is it embroiled in civil war, as some other African countries are, and it has a relatively high literacy rate of 77 per cent. Yet, at present, only 1.5 per cent of Tanzanians are fully vaccinated. Their former leader routinely refused offers of vaccine doses for his country, only grudgingly accepting that COVID-19 was a reality shortly before his own death."

"No sensible observer would say that Tanzania’s low vaccination rate is due to “global vaccine inequity,” yet many advocates for global social justice would have you believe that the large disparity in vaccination rates around the world is driven by hoarding in the global north, thus making doses unavailable in the global south. The Tanzania case and others like it disprove this simplistic narrative."

Rupa Subramanya, National Post

A health-care worker administers the Johnson & Johnson vaccine to a woman in Soweto, South Africa, on Nov. 1. Photo by Michele Spatari/AFP

"[The patent waiver would remove one barrier to] more companies being able to produce more vaccine doses in different parts of the world which should lead to greater availability of doses and greater access to them."

"All along, we and many other public health experts have been saying that it is absolutely essential that the world scales out access to COVID vaccine."

"[Both because it is the] morally correct thing to do [and because when it comes to public health] we know that vaccinating people helps to reduce transmission, and that should decrease the chances of the variants emerging from an unvaccinated unprotected population."

Jason Nickerson, humanitarian adviser to Canada, Doctors Without Borders

Getty, OlivierLemoal

The World Health Organization is fond of excoriating the wealthy nations of the world for its selfish behaviour in focusing on inoculating their populations against the SARS-CoV-2 virus, insisting that the stock of vaccines available must be shared. The sharing program, COVAX, set up by the WHO as a method of equalization to be administered by the UN health body accepts donations from wealthy countries both in cash and kind. It also permits those countries to draw from its store of vaccines when needed, even while what it stockpiles is meant to be distributed among the less-advantaged nations of the world.

WHO director-general Tedros Adhanom Ghebreyesus has nagged first-world countries to forestall administering third, or 'booster' doses to address the issue of waning vaccine potency over time, in favour of sending those 'extra' doses to Africa and India. Now that a problematical COVID strain has been identified in South Africa that is rapidly spreading around the world, given its high transmissibility rate, and as-yet unknown virulence, the world community is anxiously awaiting word on what its outcome may spell.

 

After a recent meeting of the World Trade Organization it announced "members expressed unanimous support for maintaining the momentum of the discussions on a common intellectual property response to COVID", referring to a proposal by India and South Africa requesting a patent waiver for COVID vaccines to enable them to produce the vaccines to serve their public, bypassing the pharmaceutical companies' distribution and sales in reflection of a formula they created, patented, and have financially gained from.

In Canada, South African High Commissioner Sibongiseni Diamini-Mntambo spoke to The Canadian Press, stating that the Omicron variant emerged in South Africa as a direct result of vaccine inequality, emphasizing that in South Africa, less than a quarter of the population is fully vaccinated. Any who fail to support a patent waiver, she averred, would "rather protect the profits of pharmaceutical companies than help in the global battle against the pandemic".

"I call on the nations gathering next week for the World Trade Organization ministerial meeting to meet the U.S. challenge to waive intellectual property protections for COVID vaccines, so these vaccines can be manufactured globally", U.S. President Joe Biden said prior to the WTO meeting. The Council for Trade-Related Aspects of Intellectual Property Rights took on the issue. "Members expressed unanimous support for maintaining the momentum of the discussions on a common intellectual property (IP) response to COVID-19".

"[Delegations are] committed to continue engaging in various configurations in the coming weeks to try and harvest any outcome that may still be possible." 

 

In the Canadian House of Commons, a letter was circulated signed by Members of Parliament representing all parties; an open letter calling on support for the waiver: "Opponents of the waiver proposal argue that patent monopolies are necessary to allow firms to recover their investments in research and development. However, given that COVID-19 vaccine development was primarily financed through public investment and advanced market commitments, we strongly believe this justification does not apply."

 

According to the details examined, appraised and published by Rupa Subramanya, vaccine hesitation among populations, alongside denial of COVID threats manifest as one of the reasons for low vaccination rates in India and Africa. Where South Africa, the epicentre of the Omicron variant had a stockpile of vaccine doses it was unable to administer since vaccine hesitancy resulted in a slow rollout. At that juncture, South Africa postponed delivery of new Johnson & Jonson and Pfizer vaccines in a country where distrust of vaccines is nothing new.

 

She points out that Europe, particularly Austria, Germany and Switzerland are struggling with a fourth wave that has devastated their populations and their hospitals' ability to cope. Since the advent of vaccines, Austria has distinguished itself for, out of desperation, being the first developed country to fully lock down. Those three countries are among the wealthiest in the world and though they possess more than ample vaccine doses, they are also reflective of a high degree of vaccine hesitancy among their populations, resulting in low vaccination rates.

 

Not vaccine inequity, but the results of vaccine hesitancy, a situation reflective of that which pertains to the poor countries where the West is being informed their performance in protection of their populations is one of selfish disregard for the well-being of others on the planet without their wealth and accessibility to vaccines.  Two days ago it was announced that the White House spokesperson revealed that South Africa turned down an offer by the US to provide it with additional COVID-19 vaccines.

 

White House Press Secretary Jen Psaki speaks during a daily news briefing at the James S. Brady Press Briefing Room of the White House November 19, 2021.

Alex Wong/Getty Images

 

 

Benighted Vaccine Ignorance: Thinning of the Eastern European Population

"It's not a tall tale. I see that this disease kills, and strong immunity wouldn't be enough -- only a vaccine can offer protection."

"I'm really scared and I'm pleading with doctors to help me correct my mistake [buying a fake vaccination certificate for his travel documents hauling cargo to European points]."

"You can't heat this illness. You can buy a counterfeit certificate, but you can't buy antibodies."

"Ukrainians are slowly starting to realize there is no alternative to vaccination."

Andriy Melnik, truck driver, Kyiv, Ukraine

"We're seeing low vaccine uptake in a whole swath of countries across that part of the region [Eastern Europe]."

"Historical issues around vaccines come to play. In some countries, the whole vaccine issue is politicized."

Catherine Smallwood, Europe COVID-19 incident manager, World Health Organization

"We are on the verge of catastrophe, pushed by aggressive opponents of vaccination and the lack of funds."

"Regrettably, five workers in my ward have quit over the past week."

Dr.Serhiy Shvets, head, surgical ward, Biliaivka Hospital, Ukraine

"I'm weeping in despair when I see that 99 percent of patients in serious condition with COVID-19 are unvaccinated, and those people could have protected themselves."

"We are left struggling to save them without sufficient drugs and resources."

"Fake stories have spread widely, making people believe in microchips and genetic mutations."

:Some Orthodox priests have openly and aggressively urged people not to get vaccinated, and social networks have been filled with the most absurd rumours."

"Ukrainians have learned to distrust any authorities' initiatives, and vaccination isn't an exclusion."

Dr.Olha Kobevko infectious disease specialist, Chernivtsi Hospital, Ukraine 

A medic tends to coronavirus disease (COVID-19) patients at the intensive care unit (ICU) of Pirogov hospital in Sofia, Bulgaria, October 15, 2021. Photo: October 15, 2021. REUTERS/Stoyan Nenov

 

On the African continent, populations vulnerable to the SARS-CoV-2 virus causing COVID in every country have little option over whether or not to be inoculated against the novel coronavirus. They haven't the opportunity, since vaccines of any type and origin are scarce, and where vaccines are available they're short-dated and there is a serious lack of syringes. The WHO  calls this lack of equity. It is the wealthy countries of the world that are swimming in vaccines.

And there anti-vaxxers and vaccine-hesitant people in significant numbers represent the only deterrence to having the majority of any population inoculated against COVID. The promises made by advanced countries in the West with ample access to medical equipment and vaccine doses to provide the WHO vaccine-sharing program Covax with doses for the less advanced countries of the world are not meeting their obligations. In Europe there is no shortage of vaccines. The EU is acknowledged as having a high rate of vaccine coverage altogether.

And then, there is Eastern Europe, a dismal failure in vaccine uptake by its populations. Unsurprisingly, as a result of resistance to vaccines, the countries of Eastern Europe are facing a catastrophic rise of     COVID cases, hospitalizations and deaths. Exceptions to the widespread trend of vaccine rejection are the Baltic nations, Poland, the Czech Republic, Slovenia and Hungary. Public distrust is driving a low uptake of vaccines in other Eastern European countries, however.

 

Medical workers carry a patient suspected of having coronavirus on a stretcher at a hospital in Kommunarka, outside Moscow, Russia, Monday, Oct. 11, 2021    AP Photo/Alexander Zemlianichenko

 

There were 1,159 recorded COVID-related deaths in Russia in 24 hours, last week, the largest daily death count since the beginning of the pandemic. Roughly a third of the country's 146 million population has been fully vaccinated. In response, the Kremlin ordered a nonworking period to last to November 7. In Hungary private companies can require their employees to be vaccinated if they want to retain their employment, and government employees are required to be be vaccinated. 

Poland reported its highest number of daily infections at over 8,000 last Thursday. A mere 15 percent of the adult population in Ukraine is fully vaccinated, representing the second-lowest rate in Europe, following Armenia's 7 percent. Teachers, government employees and other workers are required to be fully vaccinated by November 8 in Ukraine to avoid suspension in pay. People may not board planes, trains or long-distance buses without proof of vaccination or a negative test.

A black market in counterfeit documents has emerged with fake vaccination certificates selling for $100 to $300. Police have opened 800 criminal cases into workers at 15 hospitals in Ukraine being involved in counterfeit certificates, with 100 mobile units deployed to track down users, according to the Interior Minister. Last week, a former lawmaker was among those arrested. In the western city of Chernivtsi, ten to 23 patients die daily of COVID, with those aged in their 30s and 40s impacted.

Believing the rumours that Western vaccines contain microchips to control people, Lidia Buiko, 72, chose the Chinese Sinovac vaccine: "Priests have urged us to think twice about getting immunized -- it would be impossible to get rid of the chip", she explained, waiting for her injection in a Kyiv clinic. It is estimated that roughly half of Ukrainian medical workers express vaccine reluctance. "The risks of misinformation to vaccination have never been  higher; nor have the stakes", commented     UNICEF representative in Ukraine Murat Sahin.

About 35 percent of vaccine-eligible adults in Romania are fully immunized where tighter restrictions are in effect requiring vaccination certificates for attending a gym, the movies or shopping malls. With a 10 p.m. curfew, shops close at 9 p.m., bars and nightclubs shuttered for 30 days, and masks are mandatory in public. 

 

Bulgaria has a quarter of its adult population fully vaccinated and reports record numbers of infections and deaths. Official data identify Bulgaria with the highest COVID-19 mortality rate in the 27-nation European Union, with 94 percent of deaths representing the unvaccinated.Authorities in Georgia launched a lottery of cash prizes to entice the population to be vaccinated, where 33 percent of the population has been fully vaccinated.

"[So many are] afraid of the vaccines because of the immense [amount of] fake information that has flooded social media and TV."

"Every day we see people arriving with shortness of breath and most of them are feeling sorry for not being vaccinated."

Dr.Dragos Zaharia, Marius Nasta Institute of Pneumology, Bucharest

"[The government's information campaign] was not designed according to the peculiarities of our country."

"The emphasis should have been done, for instance, on the Georgian Orthodox church, because we have many instances when priests are saying that vaccination is a sin."

Dr.Bidzina Kulumbegov, Georgia

A healthcare worker is waiting for patients at a Covid-19 vaccination centre at The Military Medical Academy in Sofia.

That Classic Catch-22

Nurses close the curtains of a COVID-19 patient's room at an ICU in Surrey, B.C. (Jonathan Hayward/The Canadian Press)

"A shortage of workers can mean people's health and well being. It's scary."

"We're in an ethical situation where it's also scary not to ensure that all health workers are vaccinated."

"So it's a bit of a Catch-22."

Devon Greyson, assistant professor, public health, University of British Columbia

"I have a hard time understanding how there are nurses, with scientific training, who refuse to get vaccinated."

"If I were a nurse, in the field, in a clinic with unvaccinated colleagues, I would feel uncomfortable for our patients, for myself, for our loved ones."

"Starting Wednesday, we will reach [out] to them to make a last verification on their vaccination status and if they are not adequately vaccinated, they will be suspended."

Luc Mathieu, president, Ordre des infirmieres et infirmiers du Quebec

"I feel like a terrible nurse. I bust my ass 60 hours a week for what? To hear the pandemic's over, the vaccines are a poison, COVID is a conspiracy. I'm not putting that in my body; and on and on. I work consistently short-staffed and I mean dangerously short staffed."

"Nursing was a calling for me. I always wanted to be in the medical field. Today I want to go off the grid and say f--- this. We've suffered an overwhelming trauma that I'm not so sure we are going to recover [from]."

"...Now I'm tired, I cry before my shifts, I have severe anxiety, but I still give the best care I can."

Season Foremsky, Calgary nurse, suicide

"Our front-line physicians and nurses are under extreme stress and pressure. The pandemic is impacting individuals and our teams both physically and mentally."

"Our people have been working tirelessly to care for Albertans throughout this long and exhausting pandemic."

Dr.Verna Yiu, president, CEO, Alberta Health Services

"Season's death is a red flag for every individual healthcare worker to take a pause and reflect, to say, 'I need to take care of myself."

"A lot of politicians are saying, 'Oh, just hang on, just hang on. It's the pandemic, we have no control'."

"Sorry -- we were saying the same thing before the pandemic."

Linda Silas, president, Canadian Federation of Nurses Unions

Nurses on the front line of the COVID-19 pandemic say they’ve seen many of their colleagues quit or transfer jobs because they’re burnt out after months of abuse from some patients and exhaustion from staff shortages.   CBC

 

Hospitals across Canada, already short-staffed with medical personnel, many of whom under constant pressure, have decided to leave the profession altogether, are now facing an impossible situation. A relatively small proportion of medical staff are adamantly against being vaccinated. And given that the majority see the need to be inoculated against the novel coronavirus, the presence of colleagues who are unvaccinated pose a contagion threat to themselves as well as to the patients entering hospital and trusting that they will be safe from the the highly communicable Delta strain now dominating case numbers.

The situation is such that provincial mandates as well as individual hospital and long term care homes have mandated the necessity for vaccinations for all staff to protect themselves and the vulnerable individuals in their care. Deadlines for vaccine mandates now on the near horizon, see the potential for greater staff shortages in a prevailing atmosphere of already-existing staff shortages, hugely exacerbating an already unsteady position of reliable care for patients. The overburdened workforce due to the pandemic is on track to become ever more burdened.

Health care personnel layoffs have begun, with employees being informed, due to their refusal to be inoculated against COVID, that they are being placed on unpaid leave. Employees at the Toronto Hospital network, reporting a 97 percent vaccination rate, have been informed they have until the 22nd of October to be vaccinated, or they will no longer be employees of the hospital system. British Columbia is set to place staff at long-term care and assisted living on unpaid administration leave should they fail to be vaccinated.

Quebec has offered $15,000 bonuses in hopes of attracting and retaining some 4,300 full-time nurses. In total 25,000 health-care workers not yet fully vaccinated with an October 15 deadline looming, risk being suspended without pay. In Edmonton, Louis Hugo Francescutti, an emergency room physician, worked with several hospital staff refusing vaccination, despite their employment being on the line; they are committed to reserving themselves from COVID inoculation.

In Calgary, nurse Season Foremsky wrote on social media of the toll the pandemic had taken on her mental and physical resources; the trauma of seeing people die, the abuse she suffered from anti-vaccination protesters she faced, and the tediously strenuous long work hours and lack of support. As a mother of two young children hers was a delicate balancing act to keep her head above the stress that was suffocating her. She cared for COVID-19 patients as an emergency room and intensive-care unit nurse at the South Health Campus in Calgary.

And on September 27, the once-vibrant woman was gone, dead of a suspected drug overdose that occurred at home, a suicide. One in three nurses report thoughts of suicide, according to a recent poll conducted by the Canadian Federation of Nurses Unions. Of nurses surveyed, 98 percent reported symptoms consistent with a high-to-moderate risk of suicide. Among them, fewer than ten percent attempted to access mental health services. 

That same survey noted a study of Alberta nurses saw similar or slightly elevated rates of alcohol and substance use disorders, comparable to numbers in the general population. Linda Silas, president of CFNU, speaks of nurses working "in a pressure cooker"; work shortages, worsening physical and mental health, and workplace violence are not new in their workplace, caused by the stressors surrounding the SARS-CoV-2 virus causing COVID. They were present long before the pandemic and since then, have boiled over.

Health-care workers tend to COVID-19 patients in the intensive care unit of a Toronto hospital. (Evan Mitsui/CBC)

 

The Rot Within

"Our analysis demonstrated that Canadian RWE [right-wing extremists] communities identified in this study engage in a range of harmful behaviours."

"This includes potentially illegal activity such as the incitement and glorification of violence and explicit hate speech."

"In particular, the communities studied in this report appear to act as hubs for disinformation and conspiracy theories, including content relating to the COVID-19 pandemic."

Institute for Strategic Dialogue, London report

 

"[Thousands of people are joining pandemic conspiracy movements through social media, so when doctors and public figures spread false online information] it lends conspiracy theory promoters an air of credibility."

"In some way, shape or form similar stuff like that is happening all across Canada,. It just seems like more of it is happening in Alberta now." 

"it's a very dangerous combination of things happening right now. In an environment like that, all it takes is one unstable person to try to act out the violent fantasies of the group."

Evan Balgord, executive director, Canadian Anti-Hate Network research group 

A video widely circulated online this week shows Dr. Gary Davidson, an emergency medicine physician at the Red Deer Regional Hospital Centre, accusing the government of waiting for a drop in admittance numbers to trigger a lockdown to enable it to take credit in swift action. (Kyle Green/The Associated Press)

 

The Province of Alberta stands out as the most COVID-vulnerable poster child in Canada struggling in vain to check the surge of the SARS-CoV-2 Delta strain that has been overwhelming countries the world over in its viral contagiousness. Hospitals are overwhelmed, case counts are soaring, 'elective' surgeries are once again being cancelled, death numbers increasing. The premier of the province is in a quandary, having to backtrack on opening the province too soon, now once again re-imposing a lockdown, and with it a move to COVID passports, infuriating the population.

Unable to cope with its ICUs crowded with patients and shortages, the province sent out an appeal to other provinces for help. Those that were able to oblige are receiving air-lifted COVID patients requiring emergency hospital care that Alberta hospitals are unable to service. Neighbouring Saskatchewan was one province that was unable to open its ICU doors to Alberta patients. It too is overwhelmed with COVID patients. In Alberta the influx of patients invariably reflects unvaccinated people.

Resistance by anti-vaxxers in Alberta is endemic by a wide margin in comparison to other provinces, and more prominent in outlying areas. These are people hugely resistant to the very idea that medical science is on the right track in advising populations how best to protect themselves from the virus. These are the people convinced that government is trying to control their every thought, to take away any vestiges of personal agency and independence. And they are supported by groups that feed on this unstable paranoia.

 

On social media all manner of theories abound, posing as knowledge-based solutions, from the use of horse de-wormer medications as a 'cure' for COVID, to other bizarre remedies that sometimes land people in hospital. Suspicion of government motivations is rampant. Doctors pressured by some of their patients, provide them with vaccine-exemption letters on health grounds, from enabling patients to bypass wearing masks in public to arguing that medical conditions preclude inoculation.

The Alberta College of Physicians and Surgeons is preparing to publish a letter addressed to its physician-members and the public at large, reiterating its support for vaccines and public health requirements in place to curb the spread of COVID-19. Doctors identified by the College as spreading misinformation on social media platforms have been warned that their behaviour may impact the credibility of their profession and may in fact lead to suspension of their medical practise certification.

With the highest number of unvaccinated people in the country, the spread of misinformation continues to harm the public even as case numbers explode. Sources such as not only doctors but other public workers and well-known figures including police officers, firefighters and others weigh in on their beliefs contrary to government authorities and medical community experts. One popular country singer reported to his large following that people recovered from COVID are immune thereafter to the virus.

A report out of London by the Institute for Strategic Dialogue think tank that monitors disinformation spoke of online communication channels associated with white supremacy and racism having seen exponential growth during the pandemic. 

Alberta on Tuesday reported 29 additional COVID-19 deaths, bringing the total since the pandemic began to 2,574 people. Photo by IAN KUCERAK / Postmedia

 "It's incredibly disappointing to see your profession do things that are so harmful to others."

"We're in pretty unprecedented times. There are always events where the odd physician may say or do things that are counter to traditional pratices of medicine, but not to this degree, not to this scale."

"This is just the minority of people in the profession that are creating a problem, but that minority is having a huge impact."

"Physicians do have a very powerful voice in society and people listen to it."

"I would recommend that whoever is listening to those physicians also listen to some of the other evidence that's out there with an open mind."

"Unfortunately, we see a lot of confirmation bias where people want to believe the science that they're hearing, instead of critically appraising that science." 

"[The college had an emergency meeting and] counsel made it very clear that we need to be aggressive in dealing with [doctors spreading misinformation]."

Scott McLeod, registrar, College of Physicians and Surgeons of Alberta

Taking Your Chances

"Almost half of [the vaccine-hesitant, 46 percent] live in Ontario and well over half of them [59 percent] are women. A quarter were born outside Canada. Their average age is 42 and the plurality are between 30 and 44 years old."

"If they were voting in a federal election today, 35 percent would vote Liberal, 25 percent Conservative, 17 percent NDP, nine percent Green -- pretty similar to overall voting intentions for the entire population."

Abacus Data chair Bruce Anderson

Vincent Rochester, 85, of Voorhees N.J., receives a COVID-19 vaccine at the Philadelphia VA Medical Center. “Don’t be nervous, do what is necessary and get your shot,” Rochester said.TYGER WILLIAMS / STAFF PHOTOGRAPHER

Male American radio talk show hosts have made news recently, beyond their outspoken criticism of vaccinations and government and public health officials who energetically promote COVID-19 inoculation for the entire population. A number of these naysayers vexing authorities have themselves contracted COVID, the virus they formerly categorized as a harmless cold or flu whose presence authorities have blown out of all proportion in a designed effort to frighten people into permitting government to take control of their lives.

On August 4, 65-year-old Dick Farrel called COVID[19 a "scamdemic". Then 60-year-old Ted Tucker spoke similarly disparagingly of the U.S. government efforts in persuading people to become vaccinated against the coronavirus, followed by 91 year-old Jimmy DeYoung Sr. Finally, nationally syndicated Nashville, Tennessee-based Paul Valentine, age 51, died of COVID, and then also did Florida's Marc Bernier. What they all had in common was the profile of an older male COVID skeptic.

In a move to better understand who and what kind of individual represents the majority of Canadian anti-vaxxers, people who hurl insults at political leaders currently canvassing for national votes in Canada's 44th contentious federal election, Abacus Data set out to look for numbers. In an interview, Bruce Anderson of Abacus pointed out that of Canada's 29.5 million population, seven percent (two million) profess to being hesitant over vaccinating themselves.

Six percent (1.77 million) outright refuse vaccination and will not be convinced to reconsider. 21 percent of the population in May of 2021 was seen to be vaccine-hesitant, and it would appear that these are the people who are reachable and ultimately amenable to recognizing that the fourth wave of COVID in Canada is recognized as a pandemic of the unvaccinated.

Those who refuse, as well as the not-yet-convinced hesitant, give their top reason for refusing to be vaccinated as that they "hate government telling me what to do" (90 percent of refusers and 85 percent of the hesitant), "don't trust government" (83 percent of the refusers, 66 percent of the hesitant); "are reluctant to take any vaccines" (80 percent of refusers and 83 percent of the hesitant) or "try to avoid prescriptions/take natural path" (64 percent of refusers and 65 percent of the hesitant).

 

"The hesitant aren't conspiracy theorists. They aren't angry at the world. They don't think COVID-19 is a hoax", stated Anderson. "They aren't radicals of the left or the right -- 61 percent of them say they are on the centre of the spectrum. Two-thirds achieved post-secondary education." Timid they may be, said Anderson, but not stupid. And then there are the vaccine refusers: 

"Three-quarters (73 percent) of them think COVID-19 is a hoax or greatly exaggerated. Two-thirds (69 percent) don't worry at all about getting COVID-19 (only 27 percent of the hesitant feel concerned over contracting the virus.)"

Alberta has the largest percentage of vaccine refusers, at eight percent, while Ontario, Saskatchewan and Manitoba are all at seven percent, Quebec five percent and British Columbia and Atlantic Canada are four percent refusers. "Somebody could make the case that these numbers are a little bit different, one from the other. But they're not really significantly different." Since the hesitant can be convinced or pressured to become vaccinated, Canada, believes Anderson, could move into the 90 percent-plus-range of the population who are fully vaccinated, leaving about six percent refusing.

In a 30,000 person poll stretching over months, the typical vaccine-hesitant Canadian is a 42-year-old woman living in Ontario who tends to vote Liberal. Syndicated radio host Phil Valentine bet his chance of dying from COVID to be less than one percent. He lost. Mark Valentine, Phil's brother, wrote before Phil's death: "Phil would like for his listeners to know that while he has never been an 'anti-vaxxer', he regrets not being more vehemently 'Pro-Vaccine', and looks forward to being able to more vigorously advocate that position as soon as he's back on the air, which we all hope will be soon."

Before being hospitalized and just after he tested positive for COVID, Phil Valentine spoke to his listeners urging them to consider: "If I get this COVID thing, do I have a chance of dying from it?" He said he made the decision not to be vaccinated because he felt he likely would survive a bout of     COVID-19. Reality proved him wrong.

 

An ambulance passes through a crowd of people protesting COVID-19 vaccine passports and mandatory vaccinations for healthcare workers, in Vancouver, on Wednesday, September 1, 2021. (THE CANADIAN PRESS/Darryl Dyck)

"Lately, friends have been asking me about their chances of contracting Covid-19. They are also worried about the risks of dangerous side effects to the new vaccines being approved and rolled out so fast. Why should I not know something about the odds of anything happening? After all, I am a mathematician who has written extensively about the history, mathematics, and the psychology of gambling illusions.

People are asking probability questions I cannot answer. Can anyone? Relevant data involving ferociously mind-boggling people-behavior is not available, making that kind of odds question impossible to answer."

"Two centuries ago, the typical naïve gambler knew almost nothing of the mathematics of risk. They knew, though, that drawing a full house is just about a hundred times more likely to happen than drawing a straight flush and that a straight is almost twice as likely as a flush. That knowledge was part of the cultural instinct, almost devoid of mathematics."

"We now live in a world with a virus that has killed more than 400,000 people in the U.S., now averaging well-above 3,000 a day. More than 24 million Americans have tested positive. Testing positive means your health situation could be okay or somewhere between not-good and death; moreover, it means that you have a non-zero probability of long-term consequences or death. And still, so many Americans believe that because many COVID patients beat the virus, they can too."

Joseph Mazur, Psychology Today

Medical Double Bind: St.Petersburg Delta Surge, Euro 2020 Match

"As a doctor, I am of course against the holding of any mass events."

"Of course we expect a surge in patients after such mass events are held."

Alexei Dmitriev, Mariinskaya Hospital, St.Petersburg

 

"People were going around, hugging each other."

"For me it was like living two lives in St.Petersburg. Probably there was a way to prevent what is happening now."

Alla Vitalyevna, head nurse, Mariinskaya Hospital, St.Petersburg

Finland played two of its Euro 2020 group games in St. Petersburg, Russia. At least 2,000 Finns are estimated to have traveled to the city, where Finland played two group matches. (Anton Vaganov/Associated Press )

St.Petersburg, the second most populous city in Russia reported over 100 deaths daily this past week, and on Friday it hosted the quarter-final between Spain and Switzerland, the seventh of the city's Euro 2020 matches. There were 1,247 new infection cases in St.Petersburg in the past few days, according to the national coronavirus taskforce. Two weeks earlier, Finland's team was in the city, as the least COVID-affected country in Europe with under 95,000 cases and 969 deaths. The Finnish-Russian border was closed from both sides since March 2020; St.Petersburg's population of over 5 million equals the total population of Finland.

Since Finnish soccer fans, some two thousand in number, returned home, health authorities have seen a spike in coronavirus cases traced to neighbouring Russia after exposure at the European Championship matches held in St.Petersburg. "All passengers who have traveled from St. Petersburg to Finland by any bus company [were urged by the Finnish Institute for Health and Welfare on Saturday to] apply for a coronavirus test."

 As soccer fans gathered for matches playing out at stadiums in St.Petersburg, doctors in the city were busy attempting to handle record numbers of COVID-19 deaths. Although some pandemic restrictions were imposed, including a 50 percent limit on stadium capacity and a mask requirement with restaurants to be closed between 2:00 a.m. and 6:00 p.m., caps on the numbers attending public events included, medical personnel failed to be reassured over the prospect of burgeoning cases brought on by sport attendees' exposures. 

The fact remained that fast-rising virus cases representing a wave across Russia which authorities recognize as the highly contagious Delta variant and low vaccine uptake prevailed, and one city hospital in the red zone of COVID-19 contagion, had medical workers beyond perturbed. According to the World Health Organization, crowds mixing in Euro 2020 host cities -- with travel and social restrictions easing the number of new cases appearing in Europe -- had risen by ten percent.

The Union of European Football Associations' statement that it was fully aligned with local health authorities guidelines at every venue, strictly following their measures, has done nothing to reassure local health workers that the situation is well in hand. From their perspective the matter of COVID contagion and carrying on the games with minor restrictions is courting danger. From their hospital ward where patients are on breathing support, doctors monitoring lung function and preparing oxygen tanks, the decision to carry on was a poor one.

Dr.Dmitriev pointed out that people are suffering severe respiratory symptoms even though symptoms were different during the current surge compared to earlier coronavirus waves, as opposed to the present, where minor lung damage amidst a younger age range is occurring. Head nurse Vitalyevna spoke of her shock after a day's work in the red zone then moving on into the city where barely any restrictions were being imposed. 

Italy are due to face Belgium in St. Petersburg, Russia on Friday.   -   Ryan Pierse/Pool via AP

Over a thousand Swiss fans were expected to arrive in St.Petersburg for last Friday's game after the Swiss health minister warned soccer fans it would be foolhardy to arrive in Russia without first having been inoculated with a COVID vaccine dose. This preventive well intentioned when travelling to a city where part of its problem in battling the coronavirus is Russia's relatively low vaccination rate.

"I am not here to pour cold water on any EURO 2020 fan or anyone’s holidays."

"But before we watch our players, and before we all pack and go for some well-deserved rest near home or far away, it is my imperative to give [some] messages."

"If you decide to travel and gather, assess the risks and do it safely, keeping all life-saving reflexes of masks and self-protection especially indoors and in crowds."

Hans Kluge, WHO Europe Regional Director

St. Petersburg's Gazprom Arena will be up to 50% full for seven Euro 2020 games during June and July. Peter Kovalev/TASS

The World Community Has a Right to Know

Lab-leak theories centre on the Wuhan Institute of Virology   Reuters

"[Of the lab-leak theory]: That possibility certainly exists, and I am totally in favour of a full investigation of whether that could have happened."

"[I am] not convinced [the virus originated naturally]."

Dr.Anthony Fauci, U.S. President Biden's chief medical adviser   

 

"From day one China has been engaged in a massive cover-up."

"As the evidence for the lab-leak hypothesis grows, we should be demanding the full investigation of all origin hypotheses that's required."

Jamie Metzl, a fellow at the Washington-based Atlantic Council 

 

"We do need to be a bit patient but we also need to be diplomatic."

"We can't do this without support from China. It needs to be a no-blame environment."

Prof Dale Fisher, Singapore's National University Hospital 

"I've read it, [report released by the Washington Post calling into question when and how the SARS-CoV-2 virus emerged] it's a complete lie."

"Those claims are groundless. The lab has not been aware of this situation, and I don't even know where such information came from."

Yuan Zhiming, director, Wuhan National Biosafety Lab, Wuhan Institute of Virology, Wuhan, China

The story in the Wall Street Journal claims that three laboratory workers at the Wuhan Institute of Virology fell ill in November of 2019, and were admitted to hospital for treatment. A month later, China advised the World Health Organization of the sudden appearance of a zoonotic, a virus transmitted from animal to human, and that authorities in China felt confident the virus had erupted in a fresh food market where wild animals were sold and pangolins were the suspected source.

The U.S. intelligence report cited by the paper had originally been the product of an investigation authorized by then-President Donald Trump who stated  his determination to get to the bottom of the matter that he suspected was Beijing's lack of openness in alerting the world community of the presence of a galloping new virus with unknown properties but a surprising level of lethality, initially presenting as a new kind of pneumonia. 

It was the newspaper's contention and possible purpose of re-visiting the investigative report and coming away with greater details, that what it revealed could conceivably bring support to the evidence already in question, leading to a broader and deeper investigation into what many in the scientific community suspect -- and many others object to -- that the COVID-19 virus could have been a lab escapee.

What is undeniable unless new information arises, is that the first cases of a strange new pneumonia were being reported toward the end of December 2019 in the central Chinese city of Wuhan where coincidentally two high-security laboratories for the study of viruses were located. One laboratory had undertaken studies of viruses collected from bats in caves and theorized that the bats had infected pangolins and the pangolins carried the virus with them when they were trapped for sale at the live animal market in Wuhan.

 

Although rumours have circulated widely that the SARS-CoV-2 virus causing COVID-19 was not a zoonotic that naturally occurred, infecting people who had come in contact with a vector at the Wuhan market, but rather a laboratory-produced virus and that inept, insecure methods led to its escape, China has steadfastly denied any such allegations. Claiming instead that the lab theory was unproven and nonsensical and simply represented U.S. paranoia.

 

Instead Chinese authorities point to the possibility that the virus may very well not have originated in China, or Wuhan, at all, and was imported with frozen food from some other geographic location. Wildlife trading too was cited as a source, as well as a circulating virus that had emerged elsewhere and found its way to China by some unsuspected means. China's foreign ministry rejected the claim that three lab workers had been hospitalized, characterizing it as a lie.

 

The World Health Organization, which had sent an independent team of researchers to Wuhan months ago to undertake a detailed investigation, now entertains thought of another investigation, this time perhaps without Chinese authorities' interference, although without Beijing's approval for yet another group of scientists arriving in Wuhan there can be no follow-up of the original which declared its joint opinion that no lab escape of a virus was a likely explanation for the pandemic.

 

That opinion was reached despite that there were no unescorted interviews permitted where the investigators could privately, without interference and the presence of Chinese authorities, closely question someone who might have information critical to the investigation, nor were the investigators permitted to see collected data directly relevant to the more immediate Chinese investigation of the market where purportedly the outbreak was traced to.

 

According to Tarik Jasarevic, a spokesman for WHO, the organization's technical teams were currently making decisions on whether to proceed further and if so, how. Further study was obviously required into the role of animal markets, as well as the hypothesis of a lab leak. The issue, after all, is that of a lethal, minuscule, unseen pathogen seeking out new hosts, invading body cells and replicating wildly. A virus that has in the space of a year-and-a-half killed three and a half million people worldwide.  

Knowing its true origins could help medical science more fully understand the nature of the pathogen and how best to control it. It could also lead to techniques of detection and deterrence that could help avoid future such global pandemics. As well as teach both the global medical community and governments how best to anticipate new and perhaps even more deadly invasions of viruses from wild animal to humanity.

 

The Huanan Seafood Wholesale Market in Wuhan was linked to early Covid cases   Getty Images

 

 

 

 

 

 

 

 

Canada's COVID Concerns

"...A bit of subtlety and nuance needs to be applied to people who are providing care on the front lines.' "People working in emergency departments and ICUs are a different beast than your average Canadian."

"It is not only a health and wellness issue, but a human resources issue."

"I have sent people under the age of 40 into the ICU. This wave is much more pronounced than the first two. The sheer volume of younger, healthier people coming in is quite something."

Dr.Michael Herman, Emergency physician, Queensway-Carleton Hospital, Ottawa

"[The faster vaccines can get into more arms], the sooner our community will be safe. [We would like to see front-line health workers get fully vaccinated]."

"Many of our team are exhausted, and the staffing gaps we have as a region are significant. Hopefully we can show them how much they are valued, appreciated and will be protected."

"We would welcome it if there was an opportunity for health-care workers to get their second doses sooner if there is sufficient vaccine supply."

Queensway Carleton Hospital statement

"[It is common for emergency physicians to not yet be fully vaccinated and there is a] growing unease [among them about the situation with the third COVID wave continuing to place unprecedented pressure on hospitals in Ontario]."

"They [doctors, nurses, health-care staff] feel vulnerable."

"We are not asking to be preferentially vaccinated for personal protection. We are asking for full vaccination to maintain the integrity of the emergency health system, which is fragile."

Dr. Alan Drummond, Emergency doctor, co-chair, public affairs, Canadian Association of Emergency Physicians

 

The federal government, acting on advice from health specialists appointed as a consulting body for the government which had determined that given Canada's exceedingly tight supply of vaccines, it made sense to inoculate as many Canadians in descending order of age and profession as possible, with a first dose of vaccine. Extending the time for the second dose well beyond what the pharmaceutical companies have tested for in their research and efficacy-testing trials for best practise. With the aim to vaccinate as many Canadians as possible with at least one protective dose, available vaccines would go further the experts hypothesized, and the second dose could be safely delayed.

This is the route the government chose, and the provinces, which administer health care, set about vaccinating high-risk people in descending order from the frail elderly, the health-compromised, health-care community, racialized, front-line workers in service industries and hard-struck communities to the point later on where anyone over age 18 could make appointments for vaccination. First dose given, the wait for the second would be four months on; sixteen weeks. Which does render a high degree of protection from the SARS-CoV-2 virus for most people.

However, those in the medical community who come in direct contact on a daily basis with large numbers of COVID-19 patients, in particular those suffering from the effects of strains of concern like the UK, South African or Brazilian variants should, sensibly, be given the ultimate protection of two doses, not in the time scheduled for everyone else but as originally intended by the vaccine manufacturers in line with their research results for potency and safety.

 

Emergency room physician Dr. Laura Shoots is seen in this photograph. (Natalie Johnson/CTV News Toronto)

 

The United Kingdom found itself in a situation of raging contagion and insufficient vaccines, and it pioneered the method of leaving a wider gap between the first and follow-up doses, of 12 weeks, to enable it to inoculate greater numbers of people against COVID. Canada has followed suit, but extended the wait period by an additional month. Canada is now contemplating the issue of mixing vaccines; the original vaccine dose not necessarily followed by the same vaccine administered for the second dose.

Again, the manufacturers cannot guarantee safety and efficacy with this kind of massive departure from their products' protocol. Mix-and-match is not endorsed by the makers of the vaccines. But it has been broached in light of the very real fact of vaccine shortages and the anxiety involved in ensuring that a good proportion of a country's population is vaccinated in the interests of achieving the vaunted 'herd effect' and an eventual return to social normalcy, so countries can get back to work, children back to school.

In Canada, roughly 38 percent of the population has now had one dose of vaccine, similar to the European Union where about 34 percent have received their first dose. Where Canada stands in the more refined issue of full vaccination leaves a mere 3 percent of Canadians having received both doses, as compared to nine percent in the EU. For the U.K. its 12-week gap between doses was initiated in the interests of reducing the death and communicability rate. based on:

1. How well a single dose of a vaccine prevents serious and  hospitalized COVID-19 cases;
2. The overall efficacy of a single dose of the vaccine;
3. Whether the protective effects of a single dose persist over the extended [up to 12-week] period.

Points one and two are fairly well assured; all major vaccines have a high degree of efficacy following the first dose; preventing death and hospitalization. It is point three where uncertainty steps into the picture, with no reasonably reliable evidence that a 12-week gap works; untested and unknown. Pfizer is known to have cautioned that it cannot vouch for the longevity of protection the first dose confers, all the more so with Canada's lengthy dosing interval of up to 16 weeks.

Little wonder that the medical community, reliant on the data they are aware of, through their professional understanding, and acutely aware of the vulnerability of their personal safety through constant exposure to people suffering serious effects from COVID, and likely carrying high viral loads more readily communicable, have good reason to be concerned. For themselves, for their families, and for their patients.

The government of Canada rates a  high failure mark for a number of issues critical to the COVID situation and the need to address a pandemic that has so far demolished all hope that it will be readily settled and life as normal is on the near horizon. Its first massive error was relying on China as a vaccine partner. Which led to late contracts with pharmaceutical companies to provide their vaccines for Canada. Leading to a desperation to try something experimental in the hopes that more people could be vaccinated, sooner, to reach the goal of COVID control and normalization.

Federal Health Minister Patty Hajdu prepares to receive a first dose of COVID-19 vaccine from Brian Gray, Director of Oak Medical Arts – Mountdale Pharmacy, in Thunder Bay, Ont., Friday, April 23, 2021. THE CANADIAN PRESS/David Jackson-Pool

The Mysterious Origins of SARS-CoV-2 Virus

The Huanan Seafood Market was previously identified as a location for a potential virus spillover, Dr Eddie Holmes says. Source: Getty

"The discussion was 'where could a disease emerge?' Well, here's the place -- that's why I went."

"I've been to a few of these markets, but this was a big one -- it felt like a disease incubator -- exactly the sort of place you would expect a disease to emerge."

"[There were] crates of wildlife stacked on top of each other [including fish, snakes, rodents and raccoon dogs -- known to be susceptible to COVID-19]." 

"In my mind, the wildlife trade is the most likely source of it [the virus]. The role of that market is still uncertain, but there was clearly a lot of transmission and to me it smells like there's a strong link -- we need to follow it through."

“My concern is that the finger pointing has got so bad, will that happen? I think China just doesn’t want it to be China… so then the question is, are we actually going to see all the data? I honestly don’t know. But the more the politics gets into it, the less likely we will."

Dr.Eddie Holmes, evolutionary biologist, virologist, University of Sydney

"We know how easily SARS-CoV-2 spread from minks to mink farmers in Europe."

"So it's likely the farmer was the index case who then took it to the market, where there was a super-spreading event."

Dr.Dale Fisher, infectious diseases expert, Division of Infectious Diseases, National University Hospital, Singapore

Members of the Wuhan Hygiene Emergency Response Team leaving the closed Huanan Seafood Wholesale Market in mid-January 2020    Credit: NOEL CELIS/AFP via Getty Images

According to a British scientist, recalling  his trip to China in 2014 when he was a guest of the Wuhan Centre for Disease Control and was taken by scientists there to the Huanan seafood market, back then the Chinese biologists working at the laboratory were of the solid opinion that the open air 'wet' market was a potential source for the emergence of a zoonotic; the transference of a virus from animal to man. Dr.Holmes was taken as a courtesy and a sharing among scientists to view the market for himself in the company of his scientific Chinese peers.

 

The visit, as Dr.Holmes explains the situation, was involved with a larger project to hunt down new pathogens with the potential to become pandemics in China. Of his 2014 visit, Dr.Holmes recalled the market as he saw it then which is now shuttered, as having been comprised of a sprawling network of narrow covered streets. At the time of his visit it was late afternoon, not a particularly busy time for the merchants and shoppers. He saw wildlife, dead and alive in crates. 

 

He was witness to one animal escaping its crate: "It had got out and somebody was clubbing it", he said of the animal that had been bludgeoned in front of him. He had no knowledge, he added, whether the Wuhan Centre for Disease Control had increased its disease surveillance, or had introduced safety measures in the years following his visit and before the emergence of the pandemic. 

 

This was the notorious market that gained global attention at a time when the first cases of COVID-19 -- reported originally as a 'mystery pneumonia' -- were discovered in people who worked at the Huanan market, and those who shopped there. Two-thirds of the 41 people officially identified as having COVID and hospitalized with it -- had been exposed to the market. That exposure, and the infectious virus going on to infect hundreds of thousands in Wuhan, led to the market being shuttered in January of 2020.

 

According to experts, the site is acknowledged as having had a significant role in the beginning circulation of COVID-19. "No firm conclusion", however, was contained in a report from the World Health Organization on the origins of SARS-CoV-2, to identify the precise role of the Huanan market, though there was confirmation that the virus was most likely to have leaped from bats to humans through an intermediary animal, as yet unknown.

 

Live wild animals in crates stacked on top of each other, taken in October 2014 during Dr Eddie Holmes' trip to the market   Credit: Eddie Holmes

What is indisputable is that wildlife trade in general and wet markets particularly have been recognized for a long time as being linked to emerging new pathogens. Evidence exists that SARS leaped the biological gap to humans in 2002 at markets in Guangdong, China.  

Early in 2020 Chinese researchers had collected roughly a thousand samples from the Huanan market, swabbing rubbish bins, doors and stalls, as well as stray cats and mice, and found there widespread contamination "compatible with introduction of the virus through infected people, infected animals or contaminated products". 

Four days following the first known case of COVID, the first individual with a traceable link to the market became ill on December 12, suggesting COVID-19 might have been spread under the radar in parts of Wuhan simultaneously even before circulation was amplified through the Huanan market.

 

Wet markets are widespread across China and Asia where residents can buy meat, seafood and fresh produce. Pictured is one such market in Nanning, Guangxi. Source: Getty

"When wild animals are kept in cages or pens, slaughtered and dressed in open market areas, these areas become contaminated with body fluids, faeces and other waste, increasing the risk of transmission of pathogens to workers and customers and potentially resulting in spillover of pathogens to other animals in the market."

WHO guidance report

 

"[No evidence that live wildlife was still sold at the market was found – though it was noted that both Dr Holmes’ pictures and] unverified photographs and videos in media reports [suggest otherwise – and none of 457 animal samples taken from the market between January and March 2020 tested positive for Sars-Cov-2.]"

"The manager informed the teams the market was cleaned twice a day, morning and evening. Pests and rats are sought out and killed; holes were closed. Rigorous cleaning was done once or twice a week." "Even though there are rooms above some stalls, vendors were not allowed to live in the market."

Joint WHO-China team report

Inside Huanan food market in October 2014. Dr Eddie Holmes described the site as dirty, not particularly crowded, but with areas full of wild animals in crates    Credit: Eddie Holmes