#COVID-19: Comparing provinces with other countries 21 July Update, India unreported cases

The latest charts, compiled 21 July as overall rates in Canada continue to decline along with increased vaccinations (Canadians fully vaccinated 51.7 percent, higher than USA 49.2 percent and and just behind UK 54.2 percent).

Vaccinations: All Canadian provinces ahead of USA and EU countries.

Trendline charts

Infections: No significant change but slight uptick in G7 less Canada given increased infections in UK and USA.

Deaths: No significant change.

Vaccinations: Captured above, with steady gap between Canadian provinces and G7.

Weekly

Infections: No relative change.

Deaths per million: No significant change.

Interesting and relevant analysis of India’s under-counting of COVID-19 cases:

India’s excess deaths during the pandemic could be a staggering 10 times the official COVID-19 toll, likely making it modern India’s worst human tragedy, according to the most comprehensive research yet on the ravages of the virus in the south Asian country.

Most experts believe India’s official toll of more than 414,000 dead is a vast undercount, but the government has dismissed those concerns as exaggerated and misleading.

The report released Tuesday estimated excess deaths — the gap between those recorded and those that would have been expected — to be between 3 million to 4.7 million between January 2020 and June 2021. It said an accurate figure may “prove elusive” but the true death toll “is likely to be an order of magnitude greater than the official count.”

The report, published by Arvind Subramanian, the Indian government’s former chief economic adviser, and two other researchers at the Center for Global Development and Harvard University, said the count could have missed deaths occurring in overwhelmed hospitals or while health care was delayed or disrupted, especially during the devastating peak surge earlier this year.

“True deaths are likely to be in the several millions not hundreds of thousands, making this arguably India’s worst human tragedy since Partition and independence,” the report said.

The Partition of the British-ruled Indian subcontinent into independent India and Pakistan in 1947 led to the killing of up to 1 million people as gangs of Hindus and Muslims slaughtered each other.

The report on India’s virus toll used three calculation methods: data from the civil registration system that records births and deaths across seven states, blood tests showing the prevalence of the virus in India alongside global COVID-19 fatality rates, and an economic survey of nearly 900,000 people done thrice a year.

Researchers cautioned that each method had weaknesses, such as the economic survey omitting the causes of death. 

Instead, researchers looked at deaths from all causes and compared that data to mortality in previous years — a method widely considered an accurate metric. 

Researchers also cautioned that virus prevalence and COVID-19 deaths in the seven states they studied may not translate to all of India, since the virus could have spread worse in urban versus rural states and since health care quality varies greatly around India. 

And while other nations are believed to have undercounted deaths in the pandemic, India is believed to have a greater gap due to it having the world’s second highest population of 1.4 billion and its situation is complicated because not all deaths were recorded even before the pandemic. 

Dr. Jacob John, who studies viruses at the Christian Medical College at Vellore in southern India, reviewed the report for The Associated Press and said it underscores the devastating impact COVID-19 had on the country’s under-prepared health system. 

“This analysis reiterates the observations of other fearless investigative journalists that have highlighted the massive undercounting of deaths,” Jacob said.

The report also estimated that nearly 2 million Indians died during the first surge in infections last year and said not “grasping the scale of the tragedy in real time” may have “bred collective complacency that led to the horrors” of the surge earlier this year.

Over the last few months, some Indian states have increased their COVID-19 death toll after finding thousands of previously unreported cases, raising concerns that many more fatalities were not officially recorded.

Several Indian journalists have also published higher numbers from some states using government data. Scientists say this new information is helping them better understand how COVID-19 spread in India.

Murad Banaji, who studies mathematics at Middlesex University and has been looking at India’s COVID-19 mortality figures, said the recent data has confirmed some of the suspicions about undercounting. Banaji said the new data also shows the virus wasn’t restricted to urban centers, as contemporary reports had indicated, but that India’s villages were also badly impacted.

“A question we should ask is if some of those deaths were avoidable,” he said.

Source: https://apnews.com/article/business-science-health-india-pandemics-334c326d86efa73a0631bf7cb6e3f92e?utm_source=Sailthru&utm_medium=email&utm_campaign=MorningWire_July20&utm_term=Morning%20Wire%20Subscribers

Black Canadians more likely to be hesitant about COVID-19 vaccines, survey suggests

Not just governments but governments do have a role in reducing economic barriers to vaccination (paid time off work etc). Access has become less of an issue given pop-up and other clinics, compared to earlier periods when it was more significant:

Black Canadian leaders say governments must do more to help overcome vaccine hesitancy in their communities.

Toronto orthopedic surgeon Dr. Ato Sekyi-Otu, leader of the health-care task force of the Black Opportunity Fund, says a new survey confirms unpublished public health data that hesitancy is higher among Black Canadians than among white or non-Black racialized people.

“There’s a 20-point gap with respect to the rate of vaccination in Black Canadians compared to the Canadian average,” Sekyi-Otu said in an interview. “When you look at vaccine confidence, unvaccinated Black Canadians are least likely to say that they’ll definitely get the vaccine.”

Sekyi-Otu said the Black Opportunity Fund partnered with the African Canadian Civic Engagement Council and the Innovative Research Group to try to understand why Black Canadians appeared to be getting vaccinated in lower numbers.

The survey found that as of early June, when more than 60 per cent of Canadians had received at least one dose of the COVID-19 vaccine, 45 per cent of Black Canadians surveyed said they were at least partially vaccinated, compared with 65 per cent of white Canadians and 43 per cent of non-Black visible minorities.

Sixty per cent of Black Canadians surveyed who didn’t have at least one dose expressed some level of hesitancy to get vaccinated, compared with 55 per cent of white Canadians and 44 per cent of non-Black visible minorities.

The figures are in line with vaccination data in Toronto, where the neighbourhoods with the lowest vaccination rates also have some of the largest Black populations.

Dunia Nur, president of the African Canadian Civic Engagement Counsel based in Edmonton, said addressing hesitancy in Black communities will require “a variety of policy shifts” from government that take into consideration language needs, as well as differences in education and socio-economic disparities.

“These include investing in strategies that work with Black-led and Black-focused community organizations to address COVID-19 vaccine knowledge gaps and related trust barriers,” Nur said in a statement.

Black Canadians responding to the survey were less likely to be hesitant about vaccines if they trusted their health-care providers and the vaccine makers, could take paid time off work to get vaccinated, and were confident in where and how to go about getting a shot.

“When we talk about hesitancy, we speak about the ABCs,” said Sekyi-Otu. “I’m talking about access, belief and confidence.”

He said access is affected when Black Canadians are more likely to work in jobs where taking paid time away to be vaccinated is difficult or impossible. Belief in the vaccines can be eroded if you don’t trust the people providing the information about them, and confidence that the vaccines work is harmed when people who are already less trusting of the health-care system get mixed messages about vaccine safety and effectiveness.

“It’s not surprising that if someone has a bad experience with one institution, for example, criminal justice, when he or she is 19 years old, he or she may not want to take the vaccine in 2021 when he or she is 45 years old,” he said.

Sekyi-Oto says governments need to ensure that people can take time off work to be vaccinated and take immediate steps to provide culturally sensitive and appropriate delivery and education about vaccines in Black communities.

“You have to build a system where the people who are leading the system look like the people using the system,” he said. “And so we want to create a culturally sensitive system, engage with the community so that they can come up and take the vaccine.”

The survey is being released as the Public Health Agency of Canada reports new data showing COVID-19 death rates in the first eight months of the pandemic were highest in communities with lower incomes and higher visible minority populations.

The data is the latest report from the agency that outlines the inequities surrounding COVID-19 in Canada.

Source: Black Canadians more likely to be hesitant about COVID-19 vaccines, survey suggests

#COVID19 Immigration Effects – May 2021

Updated data across all immigration programs. Given the travel restrictions and shutdowns spring 2021, some of the monthly percentage increases are exceedingly high, with comparisons to May 2019 more meaningful. 

Some of the highlights: 

  • 2021 Permanent Resident numbers to date remain below 2019 levels, 109,615 Jan-May 2021 compared to 125,850. To meet 2021 target of 401,000, over 40,000 new PRs per month needed over the next 7 months. Given the various measures taken to date, a stretch but not impossible. 
  • The decline in Permanent Resident admissions partially reflects decline in TR to PR transitions, perhaps suggesting limited existing “inventory,” with PR applications also down 
  • Temporary Residents relatively less affected with numbers fairly stable 
  • Slight decline in study permit applications and study permits 
  • Asylum claimants stable at low levels 
  • Citizenship slight recovery in numbers but still much lower than pre-pandemic 
  • Visitor visas remain largely shut down. 

#COVID-19: Comparing provinces with other countries 14 July Update

The latest charts, compiled 14 July as overall rates in Canada continue to decline along with increased vaccinations (Canadians fully vaccinated 45.6 percent, higher than EU countries, just slightly behind USA 48.6 percent and UK 52.4 percent).

Vaccinations: All Canadian provinces ahead of USA and EU countries.

Trendline charts

Infections: No significant change

Deaths: No significant change.

Vaccinations: Captured above, with increasing gap between Canadian provinces and G7.

Weekly

Infections: No relative change.

Deaths per million: No significant change.

#COVID-19: Comparing provinces with other countries 6 July Update, Economist Normality Index

The latest charts, compiled 6 July as overall rates in Canada continue to decline along with increased vaccinations (still largely first dose, Canadians fully vaccinated 36.6 percent, comparable to or higher than most EU countries). Steep upward trend as per Globe chart below suggests gap between USA and UK fully-vaccinated will continue to narrow.

Vaccinations: All Canadian provinces ahead of USA, China now ahead of Germany and other EU countries.

Trendline charts

Infections: No significant change

Deaths: No significant change.

Vaccinations: Captured above.

Weekly

Infections: No relative change.

Deaths per million: No significant change.

Interesting integration of various data sources to develop a normality index (Canada is 63.4, slightly below the number for all countries, ranking 35, just ahead of UK):

Since the onset of the coronavirus pandemic in early 2020 many have wondered when the world will return to “normal”. But whether things will ever go back to the way they were is unclear: remote working looks set to continue, for example, and going to the movies may never be as popular as it used to be. 

The Economist has devised a “normalcy index” to track how behaviour has changed, and continues to change, because of the pandemic. Our index comprises eight indicators, split into three domains. The first grouping is transport and travel: public transport in big cities; the amount of traffic congestion in those same cities; and the number of international and domestic flights. The second looks at recreation and entertainment: how much time is spent outside the home; cinema box-office revenues (a proxy measure for cinema attendance); and attendance at professional sports events. The third is retailing and work: footfall in shops; and occupancy of offices (measured by workplace footfall in big cities). 

Our index covers 50 of the world’s largest economies that together account for 90% of global GDP and 76% of the world’s population. Our aggregate measure is the population-weighted average of each country’s score. The pre-pandemic level of activity is set at 100 for ease of comparison. The tracker is updated with new data once a week. 

Overall activity

The global normalcy index plummeted in March 2020 as many countries imposed draconian restrictions on their citizens. It fell to just 35 in April 2020, before improving gradually over the following months. Today it stands at 66, suggesting that the world has travelled roughly half of the way back to pre-pandemic life. Some indicators, such as traffic congestion and time spent outside, have recovered faster than others, particularly sports attendance and flights. The global average masks a lot of variation across countries. Click on the drop-down box to explore how behaviour has changed in each one.

Source:

#COVID-19: Comparing provinces with other countries 30 June Update, Canadian excess deaths

The latest charts, compiled 30 June as overall rates in Canada continue to decline along with increased vaccinations (still largely first dose, fully vaccinated 30 percent, comparable to most EU countries).

Vaccinations: Ontario ahead of USA, all provinces ahead of EU countries, China ahead of Italy in total vaccinations but lower than EU countries in terms of fully vaccinated (16 percent).

Trendline charts

Infections per million: Surge in delta variant has resulted in UK moving ahead of Italy.

Deaths per million: Canadian North now ahead of Atlantic Canada.

Vaccinations per million: Gap between Canada and other G7 countries continues to grow. Gap between China and India narrows (14.4% compared to 13.0%).

Weekly

Infections per million: UK ahead of Italy

Deaths per million: Canadian North ahead of Atlantic Canada, reflecting additional death in Yukon.

And the excess deaths report, indicating that Canadian COVID mortality has been understated (not unique to Canada):

A new study suggests Canada has vastly underestimated how many people have died from COVID-19 and says the number could be two times higher than reported.

Dr. Tara Moriarty, working group lead for the study commissioned by the Royal Society of Canada, said in an interview while most accounts have put the majority of deaths in long-term care, the new data analysis suggests the toll of COVID-19 was also heavily felt outside the homes in the community.

Many of those deaths likely occurred in lower income, racialized communities and affected essential workers, new immigrants and people living in multigenerational homes, as well as clinically frail seniors living at home, the study says.

“If we’d had some sense early on of who was dying where, if we had had a sense of just how many deaths were actually occurring … maybe people would have started looking sooner or listening sooner to people in communities who were saying, ‘It’s really really bad here, people are dying,'” Moriarty said.

“It might have provided support for those claims that might have caused some kind of action that would have saved lives.”

Moriarty said seeing Canada out of step with similar high-income countries on the proportion of long-term care deaths was a red flag that inspired the analysis by the society.

The new peer-reviewed analysis casts doubt on the widely accepted assumption that 80 per cent of Canada’s deaths due to COVID-19 occurred among older adult residents of long-term care homes.

Instead, it says at least two-thirds of deaths caused by COVID-19 in communities outside of long-term care may have been missed. That would put the proportion of deaths in long-term care at around 45 per cent, much closer to the average of 40 per cent reported by peer countries in the Organization for Economic Co-operation and Development.

The conclusion is based on a review of reports of excess deaths across Canada, the pattern of COVID-19 fatalities during the pandemic and cremation data showing a significant spike in deaths at homes versus hospitals in 2020. It also relies on antibody surveillance testing that collectively unmasked the likely broad scope of undetected COVID-19 infections.

The researchers adjusted the data to account for things like increased deaths due to the drug toxicity crisis and the expected drop in deaths linked to the pandemic because of things like reduced traffic accident rates.

The extent of “likely missed” fatalities varies by province and there are major data gaps in what was available, Moriarty said.

The knowledge gap is particularly acute in British Columbia, Saskatchewan, and Manitoba where cause-of-death data is only complete into February 2020, the report says. It was less of a problem in Quebec, where the virus accounted for all excess deaths, and Ontario.

Between Feb. 1 and Nov. 28, 2020, the study found COVID-19 deaths of about 6,000 people aged 45 and older appeared to have gone undetected, unreported or unattributed to the virus.

“This suggests that if Canada has continued to miss these fatalities at the same rate since last November, the pandemic mortality burden may be two times higher than reported,” the report says.

Eemaan Kaur Thind, a public health practitioner who looked at both detected and undetected COVID-19 deaths in racialized communities, said the results weren’t a shock given previous reports linking the communities and deaths or hospitalization rates.

The study suggests it’s likely many cases in those communities were never identified, and the resulting deaths were never counted.

“We know that a high-proportion of essential workers happen to be visible minorities,” she said.

“None of that surprised me, although it never really becomes any less hard to see the official numbers when you see something like this.”

Thind said she hopes the findings push policy-makers to listen to those most affected, many of whom raised alarms about things like the role language barriers played in access to COVID-19 testing and care.

“Data is very important but I think it’s more important to also listen to people and believe them.”

About 25 per cent of likely deaths occurred in people between 45 and 64, the study said.

The researchers make several recommendations, including mandating weekly preliminary reporting of deaths due to all causes to Statistics Canada, performing COVID-19 testing on all people who die in any setting, and immediately adopting methods used by the U.S. Centers for Disease Control for estimating excess mortality during the pandemic.

The group also calls for the creation of a national COVID-19 mortality task force with the provinces and territories, and independent advisers to investigate why so many Canadian COVID-19 cases and deaths have been missed or unreported, including examining demographic and employment data for those who died.

Source: COVID-19 deaths in Canada may be two times higher than reported: Study

Fadden: Canada needs a national inquiry into its handling of COVID-19

Fully agree this is needed. And hopefully, the results and recommendations will lead to action, in the short and medium term, unlike the forgetfulness following the SARS enquiries:

As COVID-19 case counts continue to decline and Canada looks optimistically ahead to our future after pandemic restrictions are lifted, it may be time to also start looking back – specifically, at how this country handled the pandemic and how we should organize ourselves to deal with the next major disruptive event. The only way this can be done comprehensively and objectively is through the establishment of a public inquiry with national scope and freedom from political interference.

Two points can be made in favour of such an inquiry. The first is that it is indisputable that the pandemic could have been better handled. We were not properly prepared and many of the decisions taken from the very beginning were the wrong ones, or were at least not explained nearly as clearly as they might have been. The expiry of much of our national stockpile of personal protective equipment and the confusing initial advice on the wearing of masks are just two examples. A careful examination of the reasons for these types of mistakes could help us avoid repeating them in the future.

The second point underlying the need for an inquiry is the worldwide consensus that serious disruptive events will continue to occur and are likely to grow in intensity and variety. Other pandemics, flooding, fires or migration are the most obvious and likely. To fail to better prepare for such events will border on criminal, and proper planning requires a clear understanding of how the management of past events can be improved upon.

There are a number of ways to review our management of the current pandemic, but nothing short of a nationally oriented public inquiry established by – but not beholden to – the federal government will do. Internal reviews by the public service would be too narrow and they would be undertaken by the very institutions whose activities and advice need to be reviewed. Review by Parliament would fall prey to the excessive partisanship that seems to govern relations within our various legislatures. Auditors general will have a contribution to make to our understanding of what happened, but they are limited to their respective jurisdictions and have little if any ability to consider activity in the private sector and in civil society.

The COVID-19 crisis is unquestionably a national and international challenge that paid little attention to borders, and as such the inquiry must be structured to allow for a review of all aspects of how Canada fared. Three issues should be of particular focus.

The first is the need to consider to what extent Canada should ensure that certain essential goods be available, no matter what. This is not a matter for governments alone; it requires the participation of the business sector and the provinces.

The second issue is one of personal freedoms. We live in a country of rights and responsibilities, and that balance always needs to be carefully calibrated. The question of whether an individual’s right to refuse public health advice supersedes government efforts to ensure the greater good needs at least some measure of resolution.

The third issue involves the roles and responsibilities of the numerous levels of government within Canada, as well as the roles of other countries and of international institutions. The management of interprovincial and international borders is perhaps the most obvious example of something in this area that needs to be probed. The broad distribution of responsibility and action to deal with COVID-19 may or may not have been essentially correct. Either way, it needs an objective review to determine if any adjustments are necessary for the future.

A process like this could also help us recognize and fortify our strong points. The objective of an inquiry is not to assume bad faith or assign blame, but rather to look into what was done and how, with a view to proposing corrective action. Any inquiry must recognize what went well. In this respect, the relatively positive response of the public to instructions and the general level of co-operation between the federal and provincial governments (as evidenced by many First Minister virtual meetings) need mention.

Given the number of deaths Canada has seen throughout this pandemic, the enormous social and economic adjustments Canadians have made, and the unprecedented cost to taxpayers, this country needs a credible, practical and comprehensive look at how we can be better prepared for the next pandemic. A public inquiry established by the federal government, but independent of it, is the only practical vehicle to accomplish this. It needs to be set up before the next election to prevent its work from becoming a matter of partisan debate. Now is not too soon to get started.

Richard Fadden is a former national security adviser to the prime minister. He was director of the Canadian Security Intelligence Service from 2009 to 2013 and served as deputy minister of national defence from 2013 to 2015.

Source: https://www.theglobeandmail.com/opinion/article-canada-needs-a-national-inquiry-into-its-handling-of-covid-19/

#COVID-19: Comparing provinces with other countries 23 June Update, China’s vaccine diplomacy

The latest charts, compiled 23 June as overall rates in Canada continue to decline along with increased vaccinations (still largely first dose, fully vaccinated 20.8 percent, most EU countries are between 25 to 35%).

Vaccinations: Minor relative changes with Ontario ahead of Quebec and British Columbia. China’s vaccination rate continues to grow dramatically (about 16% fully vaccinated. Article below charts describes lower efficacy of Chinese-made vaccines.

Trendline charts

Infections per million: No relative changes.

Deaths per million: No relative change.

Vaccinations per million: Canadian vaccination rates continue to exceed G7 less Canada. Vaccination rate increase in immigration source countries driven by China (up 16% from last week) with Indian vaccination rates up 12.5% compared to last week.

Weekly

Infections per million: No relative change.

Deaths per million: No relative changes.

They Relied on Chinese Vaccines. Now They’re Battling Outbreaks

Interesting data on the relative weakness of Chinese vaccines, likely to undermine the Chinese government’s vaccine diplomacy:

Mongolia promised its people a “Covid-free summer.” Bahrain said there would be a “return to normal life.” The tiny island nation of the Seychelles aimed to jump-start its economy.

All three put their faith, at least in part, in easily accessibleChinese-made vaccines, which would allow them to roll out ambitious inoculation programs when much of the world was going without.

But instead of freedom from the coronavirus, all three countries are now battling a surge in infections.

China kicked off its vaccine diplomacy campaign last year by pledging to provide a shot that would be safe and effective at preventing severe cases of Covid-19. Less certain at the time was how successful it and other vaccines would be at curbing transmission.

Now, examples from several countries suggest that the Chinese vaccines may not be very effective at preventing the spread of the virus, particularly the new variants. The experiences of those countries lay bare a harsh reality facing a postpandemic world: The degree of recovery may depend on which vaccines governments give to their people.

In the Seychelles, Chile, Bahrain and Mongolia, 50 to 68 percent of the populations have been fully inoculated, outpacing the United States, according to Our World in Data, a data tracking project. All four ranked among the top 10 countries with the worst Covid outbreaks as recently as last week, according to data from The New York Times. And all four are mostly using shots made by two Chinese vaccine makers, Sinopharm and Sinovac Biotech.

“If the vaccines are sufficiently good, we should not see this pattern,” said Jin Dongyan, a virologist at the University of Hong Kong. “The Chinese have a responsibility to remedy this.”

Scientists don’t know for certain why some countries with relatively high inoculation rates are suffering new outbreaks. Variants, social controls that are eased too quickly and careless behavior after only the first of a two-shot regimen are possibilities. But the breakthrough infections could have lasting consequences.

In the United States, about 45 percent of the population is fully vaccinated, mostly with doses made by Pfizer-BioNTech and Moderna. Cases have dropped 94 percent over six months.

Israel provided shots from Pfizer and has the second-highest vaccination rate in the world, after the Seychelles. The number of new daily confirmed Covid-19 cases per million in Israel is now around 4.95.

In the Seychelles, which relied mostly on Sinopharm, that number is more than 716 cases per million.

Disparities such as these could create a world in which three types of countries emerge from the pandemic — the wealthy nations that used their resources to secure Pfizer-BioNTech and Moderna shots, the poorer countries that are far away from immunizing a majority of citizens, and then those that are fully inoculated but only partly protected.

China, as well as the more than 90 nations that have received the Chinese shots, may end up in the third group, contending with rolling lockdowns, testing and limits on day-to-day life for months or years to come. Economies could remain held back. And as more citizens question the efficacy of Chinese doses, persuading unvaccinated people to line up for shots may also become more difficult.

One month after receiving his second dose of Sinopharm, Otgonjargal Baatar fell ill and tested positive for Covid-19. Mr. Otgonjargal, a 31-year-old miner, spent nine days in a hospital in Ulaanbaatar, the capital of Mongolia. He said he was now questioning the usefulness of the shot.

“People were convinced that if we were vaccinated, the summer will be free of Covid,” he said. “Now it turns out that it’s not true.”

Beijing saw its vaccine diplomacy as an opportunity to emerge from the pandemic as a more influential global power. China’s top leader, Xi Jinping, pledged to deliver a Chinese shot that could be easily stored and transported to millions of people around the world. He called it a “global public good.”

Mongolia was a beneficiary, jumping at the chance to score millions of Sinopharm shots. The small country quickly rolled out an inoculation program and eased restrictions. It has now vaccinated 52 percent of its population. But on Sunday, it recorded 2,400 new infections, a quadrupling from a month before.

In a statement, China’s Foreign Ministry said it did not see a link between the recent outbreaks and its vaccines. It cited the World Health Organization as saying that vaccination rates in certain countries had not reached sufficient levels to prevent outbreaks, and that countries needed to continue to maintain controls.

“Relevant reports and data also show that many countries that use Chinese-made vaccines have expressed that they are safe and reliable, and have played a good role in their epidemic prevention efforts,” the ministry said. China has also emphasized that its vaccines target severe disease rather than transmission.

No vaccine fully prevents transmission, and people can still fall ill after being inoculated, but the relatively low efficacy rates of Chinese shots have been identified as a possible cause of the recent outbreaks.

The Pfizer-BioNTech and Moderna vaccines have efficacy rates of more than 90 percent. A variety of other vaccines — including AstraZeneca and Johnson & Johnson — have efficacy rates of around 70 percent. The Sinopharm vaccine developed with the Beijing Institute of Biological Products has an efficacy rate of 78.1 percent; the Sinovac vaccine has an efficacy rate of 51 percent.

The Chinese companies have not released much clinical data to show how their vaccines work at preventing transmission. On Monday, Shao Yiming, an epidemiologist with the Chinese Center for Disease Control and Prevention, said China needed to fully vaccinate 80 to 85 percent of its population to achieve herd immunity, revising a previous official estimate of 70 percent.

Data on breakthrough infections has not been made available, either, though a Sinovac study out of Chile showed that the vaccine was less effective than those from Pfizer-BioNTech and Moderna at preventing infection among vaccinated individuals.

A representative from Sinopharm hung up the phone when reached for comment. Sinovac did not respond to a request for comment.

William Schaffner, medical director of the National Foundation for Infectious Diseases at Vanderbilt University, said the efficacy rates of Chinese shots could be low enough “to sustain some transmission, as well as create illness of a substantial amount in the highly vaccinated population, even though it keeps people largely out of the hospital.”

Despite the spike in cases, officials in both the Seychelles and Mongolia have defended Sinopharm, saying it is effective in preventing severe cases of the disease.

Batbayar Ochirbat, head researcher of the Scientific Advisory Group for Emergencies at Mongolia’s Ministry of Health, said Mongolia had made the right decision to go with the Chinese-made shot, in part because it had helped keep the mortality rate low in the country. Data from Mongolia showed that the Sinopharm vaccine was actually more protective than the doses developed by AstraZeneca and Sputnik, a Russian vaccine, according to the Health Ministry.

The reason for the surge in Mongolia, Mr. Batbayar said, is that the country reopened too quickly, and many people believed they were protected after only one dose.

“I think you could say Mongolians celebrated too early,” he said. “My advice is the celebrations should start after the full vaccinations, so this is the lesson learned. There was too much confidence.”

Some health officials and scientists are less confident.

Nikolai Petrovsky, a professor at the College of Medicine and Public Health at Flinders University in Australia, said that with all of the evidence, it would be reasonable to assume the Sinopharm vaccine had minimal effect on curbing transmission. A major risk with the Chinese inoculation is that vaccinated people may have few or no symptoms and still spread the virus to others, he said.

“I think that this complexity has been lost on most decision makers around the world.”

In Indonesia, where a new variant is spreading, more than 350 doctors and health care workers recently came down with Covid-19 despite being fully vaccinated with Sinovac, according to the risk mitigation team of the Indonesian Medical Association. Across the country, 61 doctors died between February and June 7. Ten of them had taken the Chinese-made vaccine, the association said.

The numbers were enough to make Kenneth Mak, Singapore’s director of medical services, question the use of Sinovac. “It’s not a problem associated with Pfizer,” Mr. Mak said at a news conferenceon Friday. “This is actually a problem associated with the Sinovac vaccine.”

Bahrain and the United Arab Emirates were the first two countries to approve the Sinopharm shot, even before late-stage clinical trial data was released. Since then, there have been extensive reports of vaccinated people falling ill in both countries. In a statement, the Bahraini government’s media office said the kingdom’s vaccine rollout had been “efficient and successful to date.”

Still, last month officials from Bahrain and the United Arab Emirates announced that they would offer a third booster shot. The choices: Pfizer or more Sinopharm.

Source: https://www.nytimes.com/2021/06/22/business/economy/china-vaccines-covid-outbreak.html?searchResultPosition=1

Canada’s data gaps hampered pandemic response, hurting vaccination tracking: report

An area that governments need to address:

The pandemic has exposed significant problems with how Canada gathers and processes data on everything from case numbers to vaccinations, which has hurt the country’s response to COVID-19, a new report conducted for the federal government says.

Canada could not track the spread of the virus as effectively as it needed to last year, according to a report prepared by the Pan-Canadian Health Data Strategy Expert Advisory Group that will be made public Thursday. The country is now struggling to keep tabs on vaccine effectiveness because of flaws in the system, including how different jurisdictions record and share information.

These data gaps, created by a patchwork of health systems that don’t always work together and often code data in different ways, need to be addressed with a national approach, the report warns.

“There is no doubt that our response to the pandemic has been severely limited as a result,” says an advance copy of the report, which was reviewed by The Globe and Mail.

The report was ordered by Ottawa last year to examine data problems exposed by COVID-19. The group will put together a list of recommendations to the Public Health Agency of Canada and other departments on how to fix these weaknesses, said Vivek Goel, who chaired the review.

When the COVID-19 outbreak hit, problems in reporting new cases, symptoms and other crucial data became apparent in Canada’s patchwork system. Since provincial and territorial jurisdictions don’t necessarily use the same standards for collecting or codifying information, pooling crucial data on a national level became difficult.

“Early on it was challenging to get a full national picture, even of basic case counts,” Dr. Goel said, noting that crucial information such as the sites of the outbreaks, or the occupations of those who became ill, weren’t always collected, codified, or shared between health jurisdictions. This prevented policy makers from knowing where and how hot spots were developing, and where the next crisis might be lurking.

“That [information] is something that is collected on the front lines of public health as people do their interviews, or it is collected at the time someone goes for testing. But if it’s not collected in a consistent way in every place and then coded and loaded into the system, we don’t wind up with a good picture,” Dr. Goel said.

“I would say if we had some of that information in a more timely manner, we might have had some decisions [by the government] being made sooner,” Dr. Goel said.

The country got better at processing information as the pandemic progressed, but “Canada had had some pretty significant challenges early on in even getting some of that basic data shared and uploaded,” he said.

These data gaps have become magnified as the country tries to mount a rapid immunization campaign across those same varied jurisdictions. Lacking the ability to quickly and effectively pool data from around the country, Canada is struggling to track, in real time, how effectively the vaccines are working in the broader population.

“Probably the most important question around vaccination in Canada is around the effectiveness of the vaccines in the real world with the dosing schedules and approaches that we’ve taken in Canada, because we’re the country that’s taken the longest dose interval,” Dr. Goel said.

“We’ve got reports that have started to come out, but they’re coming out at the provincial level,” he said. “We don’t have a national report, and every province’s systems are slightly different. So we wind up with slightly different estimates. They’re not going to be comparable.”

More detailed data on vaccine uptake is also difficult to compile, he said. “We need to have data coming together around how many people have been immunized by age group, occupation codes, all sorts of information. For example, people want to know how many teachers have had [the vaccine]. But we don’t have systems that really allow us to easily bring that kind of data together,” Dr. Goel said.

Questions specific to Canada, such as the effectiveness of mixing vaccines, are also hard to answer without properly collecting and analyzing data from across the country, he said. “We’ve got more of this mixing and matching coming up, so we need to be generating real-world evidence on how well it’s working,” Dr. Goel said.

The findings echo a report by the Auditor-General of Canada in March that said the government lacked proper data procedures to accurately track the spread of the virus. Dr. Goel said the issues are due to a number of causes, from lack of investment and concerns over privacy breaches to provinces simply wanting to oversee their own systems.

He also noted that various reports and governments have tried to address these issues in the past, but the problems were never fixed. After the 2003 SARS outbreak, Ottawa oversaw the creation of a database system known as Panorama, intended to improve infectious-disease surveillance and immunization tracking on a national level. However, the project struggled to gain support, ran into numerous roadblocks and was never effective.

“Despite all these good intentions, we don’t seem to make the progress we’d like to see,” said Dr. Goel, a professor at the University of Toronto’s Dalla Lana School of Public Health who is leaving to become president of the University of Waterloo next month.

The report calls for Ottawa to work with provinces and territories, as well as First Nations, Inuit and Métis organizations, to build a system where health data, including information on outbreaks and immunization, can be pooled effectively, and governments can act faster. Overcoming privacy concerns is a key challenge, and any such initiative must ensure that personalized information is protected, the report says.

“We need to tackle the root causes of the problems that have plagued our ability to make progress toward a common aim for all Canadians,” the report says. “Put simply, our systems, processes and policies are geared towards an analog world, while we live in a digital age.”

Dr. Goel said there are several examples of countries that collect, share and process data better than Canada, while still protecting privacy and respecting regional autonomy. Several Scandinavian countries have systems Canada should seek to emulate, he said, while the British, despite having data challenges of their own, have a more effective surveillance system implemented across England, Scotland, Wales and Northern Ireland.

“There are models for how we could approach that in Canada, but until we get to the point where we work together on these things, we wind up with these siloed sorts of approaches across the country,” Dr. Goel said.

“These issues have been underscored through Canada’s response to COVID-19,” the report says. The challenges include “timely collection and use of testing, case and vaccination data; assessing impacts of the pandemic in specific populations; sharing genomic data for management of variants; and the persistent challenges of long-term care.”

Source: https://www.theglobeandmail.com/canada/article-canadas-data-gaps-hampered-pandemic-response-hurting-vaccination/

#COVID19 impact on #immigration and related programs, April 2021 update

The latest monthly update (May for web traffic). Slide 3 has the summary numbers and changes.

Slight dip in number of Permanent Resident admissions compared to March, annualized rate now 275,000 (although likely to increase given the various policy measures announced (e.g., lowering of minimum CRS scores, special temporary program and Hong Kong measures).

Citizenship started to recover compared to earlier months but still far lower than historic levels.

Given the extremely low levels in all programs in April 2020 (travel restrictions and shutdowns), the year-over-year increases appear spectacular. Compared to April 2019, of course, changes are more modest and provide a more accurate picture of the impact.