Transparency and Long Term Vision (1)

Ian Barrett

As we emerge from the worst of the Omicron wave of the pandemic, the world is beginning to plan how to live with Covid.  Several provinces here in Canada as well as countries across the world have released plans for winding down longstanding Covid measures such as vaccine passports and mask mandates.  Still, it’s difficult to pin down exactly what “life with Covid” will look like.

One essential component of this will be respectful public debate.  With the urgency of the early part of the pandemic fading, major decisions can’t be made exclusively by a small group of people.  Voices from across society will need a say in crafting what daily life will look like over the coming years.

Respectful debate about health policy has been at times drowned out by more passionate exchanges over the last two years.  However, the Globe and Mail recently published a very interesting article by Norman Doidge, a medical doctor and executive director of Health and the Greater Good, an organization pushing for more transparency in health care.  This article raised very interesting points that don’t always get the attention they deserve.  One was the importance of finding new treatments for Covid that go beyond vaccines.  Vaccines are very effective at preventing hospitalizations and death, unquestionably our primary goal.  Yet with variants causing ever more breakthrough infections in vaccinated individuals, especially those with preexisting conditions, having more tools in our tool belt will certainly help us to keep death rates as low as possible. 

Another point raised by the article is the importance of stating when we are unsure, something bound to happen given the limited data we’ve been dealing with throughout the pandemic.  We’ve all been extremely anxious to put Covid behind us.  Yet we presented Covid vaccines as a silver bullet over the last year, with only short term studies available on their effectiveness.  How they held up long term was unknown, yet we were told that when enough people were vaccinated, often with references to 75% or 80% of the population, the pandemic would be over.

An unintentional consequence of this is that disappointment with how things turned out over the last year could drive down vaccination rates for many diseases beyond Covid.  Even seeing vaccination rates for diseases like polio and measles drop to 85% would be quite devastating.

Moreover, in the face of variants it’s unclear how much or even if Covid vaccines substantially reduce transmission.  Booster shots are certainly important to maintain high levels of protection from severe outcomes, in particular for the elderly and those with pre-existing health complications.  Yet early data from Israel and Britain, countries that have been at the forefront of vaccination efforts, suggests that the extra protection afforded by a third dose may significantly weaken after as little as ten weeks.  Israel is now rolling out a fourth dose.  By having these conversations up front and early, we can avoid disillusionment and disappointment later on.

Frank discussion and debate are the best antidotes to conspiracy theories and nasty public discourse.