#COVID-19: Comparing provinces with other countries 2 February Update

While infections appear to have plateaued, lagging indicators such as hospitalizations, ICU use, and deaths have not for the most part.

Vaccinations: Some minor shifts but general convergence among provinces and countries. Canadians fully vaccinated 80.3 percent, compared to Japan 79 percent, UK 72.5 percent and USA 64.6 percent.

Immigration source countries are also converging: China fully vaccinated 87.8 percent (numbers have not budged over past two weeks), India 52.3 percent, Nigeria 2.7 percent (the outlier), Pakistan 38.1 percent, Philippines 54.7 percent.

Trendline Charts:

Infections: Moving towards a possible plateauing in most Canadian provinces, G7 less Canada still rising more steeply than Canada.

Deaths: No relative changes but Quebec uptick remains highly visible.

Vaccinations: No major change but Alberta and Prairies continue to be laggards compared to other provinces.

Weekly

Infections: UK ahead of USA, New York and California, Germany ahead of Alberta, Canadian North ahead of Canada.

Deaths: Australia ahead of Japan.

#COVID-19: Comparing provinces with other countries 26 January Update

Steep rise of infections remains the main story, along with resulting increases in hospitalizations and ICUs.

Vaccinations: Some minor shifts but general convergence among provinces and countries. Canadians fully vaccinated 79.5 percent, compared to Japan 78.9 percent, UK 72.2 percent and USA 64.2 percent.

Immigration source countries are also converging: China fully vaccinated 87.6 percent, India 50.4 percent, Nigeria 2.6 percent (the outlier), Pakistan 37 percent, Philippines 53 percent.

Trendline Charts:

Infections: Effects of Omicron seen in steep curve in all G7 countries and provinces. No such effect in immigration source countries.

Deaths: No relative changes but Quebec uptick highly visible.

Vaccinations: Ongoing convergence among most provinces. Gap between G7 less Canada continues to grow despite overall convergence, with narrowing gap with immigration source countries save for Nigeria.

Weekly

Infections: France ahead of New York and UK, Australia ahead of Prairies, Atlantic Canada ahead of Philippines. 

Deaths: Quebec ahead of Sweden, Atlantic Canada ahead of Japan, Australia ahead of Pakistan.

#COVID-19: Comparing provinces with other countries 19 January Update

Steep rise of infections remains the main story, along with resulting increases in hospitalizations and ICUs.

Vaccinations: Some minor shifts but general convergence among provinces and countries. Canadians fully vaccinated 79 percent, compared to Japan 78.9 percent, UK 71.4 percent and USA 63.4 percent.

Immigration source countries are also converging: China fully vaccinated 87.3 percent, India 48.2 percent, Nigeria 2.5 percent (the outlier), Pakistan 36 percent, Philippines 51.8 percent.

Trendline Charts:

Infections: Effects of Omicron seen in steep curve in all G7 countries and provinces. No such effect in immigration source countries

Deaths: No relative changes but Quebec uptick more visible.

Vaccinations: Ongoing convergence among most provinces but lower rates for Alberta and Prairies. Gap between G7 less Canada continues to grow despite overall convergence, with narrowing gap with immigration source countries. Nigeria remains the laggard.

Weekly

Infections: New York ahead of UK, France ahead of USA, Australia ahead of Canada less Quebec, Atlantic Canada ahead of India. 

Deaths: No relative change.

#COVID-19: Comparing provinces with other countries 12 January Update

Steep rise of infections remains the main story, along with resulting increases in hospitalizations and ICUs.

Vaccinations: Some minor shifts but general convergence among provinces and countries. Canadians fully vaccinated 78.7 percent, compared to Japan 78.8 percent, UK 71.4 percent and USA 63.4 percent.

Immigration source countries are also converging: China fully vaccinated 87 percent, India 46.8 percent, Nigeria 2.4 percent (the outlier), Pakistan 34.7 percent, Philippines 49.4 percent.

Trendline Charts:

Infections: Effects of Omicron seen in steep curve in all G7 countries and provinces. No such effect in immigration source countries

Deaths: No relative changes but slight uptick in Quebec.

Vaccinations: Ongoing convergence among provinces and G7 less Canada and narrowing gap with immigration source countries. Nigeria remains the laggard.

Weekly

Infections: Alberta ahead of Germany, Australia and Philippines ahead of India, India ahead of Atlantic Canada. 

Deaths: Atlantic Canada ahead of Pakistan.

Fair amount of commentary on Quebec’s announcement of a health tax on the unvaccinated, with most commentary opposed to the idea. A notable exception on the right side of the political spectrum, Tasha Kheiriddin:

What to do about the unvaccinated? As Omicron tears through Canadian society, this public health question has become a political wedge issue. The Liberals and Conservatives have chosen sides, ramped up the rhetoric, and polarized the debate, each playing to the base they think is most likely to support their point of view.

With 88 per cent of Canadians over the age of 12 fully vaccinated , the Liberals figure they’re pretty safe siding with the crowd that favours the jab. Regrettably, they have chosen the strategy of demonization. On Friday, Health Minister Jean-Yves Duclos speculated provincial governments would make vaccination mandatory, which he said could be needed to get “rid” of the virus.

During the election campaign Prime Minister Justin Trudeau called the unvaccinated “misogynists and racists.” He dialled that down a bit last week when he said that Canadians are angry at the unvaccinated who take up hospital beds, but his remarks caused a furor that has yet to subside. This is not accidental.

The sad reality is that there is a subset of the unvaccinated who fit Trudeau’s description; since September, for example, some have been using the hashtag “Pureblood” on social media to self-identify as unvaccinated. You don’t have to scroll far to find tagged images peppered with shots of white supremacy gestures or MAGA hats.

The Liberals’ dogwhistle is designed to conflate these people with mainstream Conservatives — and turn people off Conservative Leader Erin O’Toole’s call for “reasonable accommodation.” O’Toole is asking for “acceptance” of the fact that up to 15 per cent of the population will not get vaccinated. He favours using rapid tests to keep unvaccinated workers on the job, as opposed to shutting down to stop the spread of the virus.

“In a population that is now largely fully vaccinated, in fact the action and inaction by the Trudeau government is normalizing lockdowns and restrictions as the primary tool to fight the latest COVID-19 variant.”

But this approach is also wrong. First, it relies on unreliable technology. Rapid tests are not good at detecting Omicron infections, particularly in the early stage when a person is infectious but shows no symptoms. Second, it sends a double message. On the one hand, the Tories encourage people to “get vaccinated.” On the other, they make allowances for those who eschew the jab. It’s like saying “wear your seatbelt, but if you don’t, that’s OK.” Well guess what — it’s not. If you get in an accident, it will cost up to three times more to treat you in hospital than if you were buckled up. Sound familiar?

The reality is that we restrict plenty of behaviours where we judge the harm to others, including economic harm, outweighs the limits to individual liberty. We don’t allow people to smoke in workplaces or public buildings. We forbid drinking and driving. And we mandate vaccination for contagious diseases such as measles if children are to attend public school. Why? Because otherwise your actions, or inaction, present a real risk of harm to someone else. They can cause quantifiable loss, in the form of sickness, suffering, even death (yes, last year 200,000 people worldwide died of measles , mostly children under five). People don’t live in a vacuum.

A liberal would cite Jean-Jacques Rousseau’s Social Contract, which called for government by popular consent; a conservative would point to Edmund Burke, who rightly observed, “Men are never in a state of total independence of each other.” In other words, there is no freedom without responsibility, no liberty without duty.

When it comes to vaccination, we should protect those who understand this truth from those who disdain it. Vaccine passports, restrictions on interaction and withdrawal of privileges are preferable to calling people names, forcing them to get the shot, or conversely accommodating a choice that puts others in harm’s way. Obliging those who opt out of vaccination to pay a penalty, such as the Quebec government is suggesting, is also a possibility. Such measures are not about cajoling or compelling, though if they do result in more vaccinations, that’s a good thing. They are meant to protect all of us who just want to move on from this once-in-a-century public emergency and get back to living our lives

Source: The unvaccinated must be deterred from harming others

#COVID-19: Comparing provinces with other countries 5 January Update and impact of Omicron

Back from my holiday break, three weeks later, the steep rise in infections due to Omicron (likely undercounted given testing constraints).

Vaccinations: Some minor shifts but general convergence among provinces and countries. Canadians fully vaccinated 78.3 percent, compared to Japan 78.7 percent, UK 71 percent and USA 62.9 percent.

Immigration source countries are also converging: China fully vaccinated 86.4 percent, India 45 percent, Nigeria 2.2 percent (the outlier), Pakistan 33.5 percent, Philippines 46.8 percent.

Trendline Charts:

Infections: Effects of Omicron becoming more apparent with steep rise in all provinces, led by Quebec.

Deaths: No relative changes.

Vaccinations: Ongoing convergence among provinces and G7 less Canada and narrowing gap with immigration source countries. Nigeria remains the laggard.

Weekly

Infections: Atlantic Canada ahead of Australia and Japan.

Deaths: No relative change

#COVID-19: Comparing provinces with other countries 15 December Update and the rise of Omicron

The latest charts, compiled 15 December, with the effects of Omicron.

Canadians fully vaccinated 77.8 percent, compared to Japan 77.7 percent, UK 70 percent and USA 61.7 percent.

Vaccinations: Numerous minor shifts but general convergence: UK ahead of Canadian North, Atlantic Canada ahead of British Columbia, France ahead of Canada, New York ahead Sweden and Australia, Prairies ahead of California, Japan behind California. China fully vaccinated 83.2 percent, India 38.4 percent, Nigeria 2 percent, Pakistan 26.8 percent, Philippines 38.9 percent.

Trendline Charts:

Infections: Effects of Omicron becoming more apparent.

Deaths: No significant relative changes.

Vaccinations: Ongoing convergence among provinces and G7 less Canada and narrowing gap with immigration source countries. Nigeria remains a laggard.

Weekly

Infections: Germany now ahead of Alberta.

Deaths: No relative change

#COVID-19: Comparing provinces with other countries 8 December Update

The latest charts, compiled 8 December. Too early to assess the impact of omicron.

Canadians fully vaccinated 77.5 percent, compared to Japan 77.4 percent, UK 69.7 percent and USA 60.8 percent.

Vaccinations: Minor shifts: Ontario ahead of Italy and Quebec, Sweden ahead of Alberta, Australia, New York and Japan. China fully vaccinated 79.5 percent, India 35.6 percent, Nigeria 1.9 percent, Pakistan 24.5 percent, Philippines 35.8 percent.

Trendline Charts:

Infections: Recent trends of increased infections in Europe continues. Canadian provincial trends showing minimal change from last week, with Quebec uptick noticeable.

Deaths: G7 less Canada (driven mainly by USA) continue to increase, Alberta has flattened while Manitoba and Saskatchewan are still increasing more than other provinces.

Vaccinations: Ongoing convergence among provinces and G7 less Canada and narrowing gap with immigration source countries given China, and to a lessor extent, India, Pakistan and the Philippines which continue to increase vaccinations. Nigeria remains a laggard.

Weekly

Infections: France now ahead of Sweden.

Deaths: No relative change

Useful analysis of vaccine equity and other challenges for many developing countries:

While vaccine inequity among African countries has played a major role in the continent’s low COVID-19 vaccination rate, experts say capacity and logistical challenges, along with vaccine hesitancy, is also creating significant challenges.

“I’ve seen a number of articles say it’s just vaccine inequity — and that’s wrong. It’s not just vaccine inequity,” said Dr. Ron Whelan, who heads health insurer Discovery’s COVID-19 task team in South Africa.

“[It’s] one part supply, one part health-system capacity and the third part is the hesitancy component,” he said.

“It is a multi-factorial problem that’s got to be solved.”

Dr. Saad B. Omer, an epidemiologist and director of the Yale Institute for Global Health, agrees it’s a more nuanced explanation than just blaming vaccine inequity for low vaccination rates across the continent.

“We expect people to land the plane with a few doses at the airport, do a photo op, [and] people to run to the airport to get their jabs. That’s never happened,” he said.

While about 76 per cent of Canada’s total population is fully vaccinated, on the African continent — home to 1.3 billion people — it’s only about 7.5 per cent, according to Our World in Data.

Delivery expected to ramp up

In October, a report by the People’s Vaccine Alliance — a coalition which advocates for equitable and sustainable use of vaccines, and includes Oxfam, ActionAid and Amnesty International — found that only one in seven COVID-19 vaccine doses promised to low-income countries were actually delivered.

However, vaccine shipments have been on the rise over the past three months and are expected to ramp up in coming weeks and over the new year, according to the World Health Organization.

Yet despite the increases in vaccine supply, experts suggest inoculation efforts in Africa could still face hurdles.

About 40 per cent of vaccines that have arrived on the continent so far have not been used, according to data from the Tony Blair Institute for Global Change, a policy think-tank.

Some countries have been forced to destroy thousands of doses of donated vaccines from their stockpiles. Namibia, for example, announced on Monday that it had to destroy 150,000 expired doses.

“It is highly regrettable that we are forced to destroy in excess of 150,000 vaccines, which have reached expiry date, because those who are eligible are refusing to be vaccinated,” Namibia President Hage Geingob is reported to have told a news conference on Monday.

According to the Washington Post, Malawi, Mozambique, Namibia, South Africa and Zimbabwe have all asked drugmaker Pfizer in the last several months to pause vaccine shipments because of challenges with uptake.

Vaccination rates vary widely across Africa and many experts are quick to note that vaccine hesitancy is not unique to the continent; it has been an issue in other parts of the globe, including the U.S and Europe. Child vaccination campaigns for various diseases, meanwhile, have been quite successful in Africa.

“Africa is, in many instances, a well-established vaccine culture overall, ” Whelan said.

But Dr. Matshidiso Moeti, the WHO regional director for Africa, recently told the New York Times that “there’s no doubt that vaccine hesitancy is a factor in the rollout of vaccines.”

News or rumours of potential side effects, she said, “gets picked out and talked about, and some people become afraid.”

1 in 4 health workers vaccinated

Additionally, only one in four of Africa’s health-care workers has been fully vaccinated against COVID-19, according to WHO. That compares to 80 per cent of health workers vaccinated in 22 mostly high-income countries.

Many of Africa’s health-care workers, including those working in rural communities, still have “concerns over vaccine safety and adverse side effects,” Moeti recently told reporters.

Capacity has also been a major issue for many African countries, specifically their health systems’ ability to absorb and distribute vaccines, particularly in rural areas, where health resources are scarce.

“We need significant capacity to deliver those vaccines,” Whelan said.

‘Weak supply chains’

That includes the need for strengthened supply chains and temperature-controlled cold chains required to store Pfizer doses, Whelan said, together with infrastructure to actually track and deliver vaccines to hospitals, clinics and other vaccination sites.

“Many of the countries have weak supply chains, particularly weak cold chain infrastructure. And the cold chain infrastructure is not well set up for the Pfizer vaccine in particular,” he said.

Some countries, including South Sudan and Congo, have had to send some vaccines back because they could not distribute them in time.

Often, Whelan said, that’s the result of issues with health-system capacity, storage capacity and administration capacity.

But reliable capacity also cannot be built without reliable access to doses, said Omer.

“When you are the head of a public health agency or a health minister in a country, you want not only doses, but also predictability in doses,” he said.

Instead, he said, many government officials “don’t know what kind of doses are coming and when they are coming.”

“Often what would happen is that [some African countries] would receive a call saying that, ‘We have doses that we are sending your way, with a month’s expiration left. Please distribute.’ That’s an obviously challenging thing for any country,” said Omer.

Last month, African Vaccine Acquisition Trust (AVAT), the Africa Centres for Disease Control and Prevention (Africa CDC) and COVAX put out a joint statement, calling the majority of vaccination donations to date “ad hoc” and “provided with little notice and short shelf lives.”

“This has made it extremely challenging for countries to plan vaccination campaigns and increase absorptive capacity,” the statement said.

“Countries need predictable and reliable supply. Having to plan at short notice and ensure uptake of doses with short shelf lives exponentially magnifies the logistical burden on health systems that are already stretched.”

According to a recent WHO statement, since last February, Africa has received 330 million doses from the COVAX program, the African Vaccine Acquisition Task Team and bilateral agreements.

Of those, more than 80 per cent have been delivered since August alone.

And so, as vaccine supply picks up, it said, “addressing uptake bottlenecks and accelerating rollout become more critical.”

Source: Vaccine inequity only partially to blame for Africa’s low vaccination rates, experts say

#COVID-19: Comparing provinces with other countries 1 December Update

The latest charts, compiled 1 December. Too early to assess the impact of omicron.

Canadians fully vaccinated 77.2 percent, compared to Japan 77.2 percent, UK 69.4 percent and USA 60 percent.

Vaccinations: Minor shifts: British Columbia ahead of Atlantic Canada, France ahead of Alberta and Japan, New York and California ahead of Prairies. China fully vaccinated 77 percent, India 32.8 percent, Nigeria 1.7 percent, Pakistan 23.2 percent, Philippines 33.6 percent.

Trendline Charts:

Infections: Recent trends of increased infections in Europe continues. Canadian provincial trends showing minimal change from last week, with some levelling off in West.

Deaths: G7 less Canada (driven mainly by USA) continue to increase, West still increasing more than other provinces.

Vaccinations: Ongoing convergence among provinces and G7 less Canada and narrowing gap with immigration source countries given China, and to a lessor extent, India, Pakistan and the Philippines continue to increase vaccinations. Nigeria remains a laggard.

Weekly

Infections: No relative change.

Deaths: No relative change

#COVID-19: Comparing provinces with other countries 24 November Update

The latest charts, compiled 24 November. Canadians fully vaccinated 76.9 percent, compared to Japan 76.6 percent, UK 69.1 percent and USA 59.7 percent.

Vaccinations: Minor shifts: UK ahead of Atlantic Canada, Italy ahead of Japan, Prairies ahead of New York. China fully vaccinated 77 percent, India 30.1 percent, Philippines 40 percent.

Trendline Charts:

Infections: Recent trends of increased infections in Europe more apparent. Canadian provincial trends showing minimal change from last week, with some levelling off in West.

Deaths: G7 less Canada (driven mainly by USA) continue to increase, West still increasing but at relatively stable rate.

Vaccinations: Ongoing convergence among provinces and G7 less Canada and narrowing gap with immigration source countries given China, India and Philippines.

Weekly

Infections: No relative change.

Deaths: No relative change

#COVID-19: Comparing provinces with other countries 17 November Update

The latest charts, compiled 17 November. Canadians fully vaccinated 76.4 percent, compared to Japan 75.8 percent, UK 68.9 percent and USA 59.4 percent.

Vaccinations: Canadian North ahead of Atlantic Canada, UK and British Columbia, Sweden and New York ahead of Prairies. China fully vaccinated 76.8 percent, India 27.6 percent, Philippines 36.5 percent.

Trendline Charts:

Infections: Recent trends of increased infections in Europe becoming more apparent. Canadian provincial trends showing minimal change from last week.

Deaths: Albert, Prairie and British Columbia deaths climb at slower à rate to G7 less Canada (driven mainly by USA).

Vaccinations: Ongoing convergence among provinces and G7 less Canada and narrowing gap with immigration source countries.

Weekly

Infections: UK ahead of USA with no other relative change.

Deaths: No relative change

And an interesting article on cognitive bias and vaccine hesitancy:

The World Health Organization recognized vaccine hesitancy as a growing challenge in 2011, and identified it as a new priority topic. This was mostly because of the return of vaccine-preventable diseases like measles in Europe and the United States

Ten years later, in 2021, we see that vaccine hesitancy has become an even more significant challenge despite all the efforts. The COVID-19 pandemic has brought it to a peak, and all efforts to manage the pandemic depend on the people’s willingness to take the vaccination. However, the numbers are not very promising as some percentage of populations in every country are reluctant to vaccinate.

Vaccine hesitancy means “delay in acceptance or refusal of vaccines despite availability of vaccination services.” Vaccine-hesitant people cite distrust in vaccine safety and concerns over vaccine adverse eventsas the most common reasons for reluctance to get vaccinated. 

Vaccines are used in healthy people to prevent a disease that might harm them in the future. However, as they are healthy at the time of vaccination, they may worry about the vaccine’s safety.

Our team of business analytics and artificial intelligence researchers at Concordia University, along with a professor of epidemiology at McGill University, has published a paper in the BMC Public Health journal that investigated this critical concern from two perspectives. 

First, we addressed vaccine safety concerns by analyzing data from vaccine adverse events systems. These are vaccine surveillance systems where adverse events following immunization are reported, monitored and stored in a database. Canada’s system is called the Canadian Adverse Events Following Immunization Surveillance System (CAEFISS).

Second, we focused on cognitive science and highlighted the critical role of cognitive biases in people’s vaccination decision-making that might lead to vaccine hesitancy.

Data-driven evidence to address vaccine safety

A solution to mitigate distrust in vaccines safety is to provide evidence-based meaningful information about vaccine safety and adverse events. We followed this path and analyzed all the adverse events reported to the U.S. Vaccine Adverse Event Reporting System (VAERS).

We analyzed almost 294,000 reports over eight years from 2011 to 2018. It equals roughly 115 reports per million people, covering 87 vaccine types. The most frequently reported vaccines were those for chickenpox, influenza, pneumococcal bacteria and human pappilomavirus (HPV).

Each VAERS report (representing one incident) involved an average of three adverse events, the most common being rashes, fever, swelling, pain and headaches. Only 5.5 per cent of the reports were marked as serious, resulting in hospitalization, disability, threats to life or death. The top adverse events in this group also include fever, pain, vomiting, headaches and shortness of breath. 

We also analyzed the vaccine adverse events reported to Canada Vigilance. Our findings were consistent with those from the VAERS.

We have provided our results in an interactive dashboard. Health-care professionals and others involved in vaccine communication can use this dashboard to provide evidence-based information to the public. Research suggests that summarized data is the best format for communicating vaccine safety information, so using this dashboard in vaccination communication can help mitigate vaccine hesitancy and safety concerns, and increase trust in vaccines.

The role of cognitive biases in vaccine hesitanc

In the second part of our study, after addressing concerns about vaccine adverse events, we examined the role of cognitive biases on vaccine hesitancy. We identified cognitive biases that might affect vaccine communication and decision-making. 

As mentioned earlier, vaccines are administrated to healthy people. When people are making decisions about vaccination, they might feel some degrees of risk, ambiguity and uncertainty about the results, which can instigate cognitive biases in the decision-making process. Such cognitive biases might nudge people toward vaccine hesitancy.

For example, contrary to the positive effect of providing people with summarized vaccine safety information that increases vaccine trust, detailed vaccine adverse event reports will decrease trust because of two cognitive biases. 

First, when vaccine hesitant people read a detailed report about a vaccine adverse event, it gives them the chance to see what they want to see. It is an example of confirmation bias, which is the tendency to recall and interpret information that confirms our existing beliefs

Second, a detailed adverse event report will also increase the event’s vividness, making it easier to recall the next time there is a decision to be made about taking a vaccine. That is the effect of availability bias, the tendency to attribute more weight to factors that are easier to recall.

We identified 15 cognitive biases in the vaccine decision-making process and categorized them into three groups:

  • Cognitive biases triggered by processing vaccine-related information include availability bias, as in the above example, as well as framing effect, base rate neglect, availability bias, anchoring effect and authority bias.
  • Cognitive biases triggered in vaccination decision-makinginclude omission bias, which is when the results of not taking an action are viewed as less damaging than the results of taking action, even when this is not the case. Others include ambiguity aversion, optimism bias, present bias and protected values. 
  • Cognitive biases triggered by prior beliefs regarding vaccination include confirmation bias such as the one in the example, as well as belief bias, shared information bias and false consensus effect.

The full list of cognitive biases affecting vaccination decision-making and their examples is available here. Public health officials and practitioners can use this list and customize their plans, interventions and other forms of vaccine communication to decrease vaccine hesitancy. 

You also can check the list and see if these biases have influenced your own vaccination decisions.

Source: https://theconversationcanada.cmail19.com/t/r-l-trtukldd-kyldjlthkt-b/