PROTECT

HEALTH WORKERS WAIT TOO LONG FOR SECOND VACCINE. FRANCIS,

The federal government’s decision to delay the second dose of life-saving COVID-19 vaccines by upwards of four months has been controversial. What is not controversial is that our heroic health-care workers deserve all the protection they can get, because they are the ones putting themselves in harm’s way on a daily basis. And yet, they too are being forced to wait unreasonably long periods of time to get the protection they need. Now, two physicians from Belleville, Ont., have gone public to explain why front-line health-care workers deserve second vaccine doses immediately.

“There is good benefit from one dose; however, if two doses provides the best protection against death, hospitalization, infection and transmission, this is the level of protection we want for our front-line healthcare workers,” wrote Dr. Michele Miron, an emergency physician, and Dr. David Weinstein, a nephrologist, on a local news website. “This level of protection is critical for the protection of individuals, the integrity of the health-care system and most importantly, the patients who need care from the system.”

They say that the implications of the dose-delay policy for the health system could be “dire,” and that partially vaccinated staff at Quinte Health Care in Belleville and at St. Mary’s Hospital in Montreal have contracted the disease.

Other physicians have complained that, even after being asked to volunteer to work in COVID wards, they have been denied a second dose. The fact that Canadian health authorities are delaying second doses for the general public is appalling, but it’s unbelievable that they have not extended full protection to front-line workers.

According to the Canadian Institute for Health Information, COVID-19 infections among Canadian health-care workers have tripled since the end of July 2020, bringing the total number of reported cases to 65,920 as of Jan. 15, 2021. And in the past six months, cases among health-care workers have increased in most provinces.

Since the start of the pandemic, 24 health-care workers have died from COVID-19 — including 12 in the last six months in Quebec, Ontario, Manitoba and Alberta.

Those working in emergency departments, intensive care units and COVID wards are at the highest risk of exposure, according to Miron and Weinstein. And the dose-delay breaches the “concept of informed consent,” which underpins medicine.

“For example, if a patient consented to a treatment consisting of two doses of a medication at a threeweek interval with a success rate of 95 per cent, it would be unlikely that the same patient would consent to an alternative treatment option consisting of two doses of the same medication given 16 weeks apart with a success rate of 60 per cent. This same concept applies to the relationship between public health officials and those on the front lines of health care,” they explained.

They also cited the position of the World Health Organization, which recommends giving health-care workers priority access to vaccines.

“Prioritization of these workers is also supported by the principle of reciprocity; they play critical roles in the COVID-19 response, working under intense and challenging conditions, putting not only themselves but also potentially their households at higher risk for the sake of others,” they write.

“We must express our utter sadness and disappointment at the delay of the second dose. We have witnessed the incredible effort and bravery of our physician colleagues, nurses, security and so many frontline staff throughout this pandemic. During the pandemic, in our region, the hospital system has oftentimes filled the void in care created by the lack of access to primary care, specialist care, mental health care, housing, drug rehabilitation, home care, public health sexual health care, imaging, elder care and by the many limitations of virtual care.”

In summary, the two physicians wrote: “Protect our health-care system. Protect our patients by protecting us. All of us. Fully. We have looked after our community for an entire year. Will our public health officials look after us?”