#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/

#COVID-19: Comparing provinces with other countries 10 November Update, Canadian excess deaths

The latest charts, compiled 10 November. Canadians fully vaccinated 75.9 percent, compared to Japan 74.6 percent, UK 68.6 percent and USA 59.2 percent.

Vaccinations: China ahead of Atlantic Canada, UK and Canadian North ahead of Quebec, Australia ahead of Prairies. China fully vaccinated 76.7 percent, India 25.5 percent, Philippines 33 percent.

Trendline Charts:

Infections: Recent trends of increased infections in Europe and elsewhere not fully apparent. Canadian provincial trends showing minimal change.

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

Vaccinations: Ongoing convergence among provinces and G7 less Canada.

Weekly

Infections: No relative change although some shifts likely in the next few weeks given outbreaks in a number of countries and provinces.

Deaths: No relative change

Meanwhile, from Statistics Canada:

Statistics Canada says more than 19,000 Canadians lost their lives during COVID-19 than would have been expected had the pandemic never happened.

The report highlights the deadly toll COVID-19 has taken directly and indirectly on Canadian lives.

According to provisional data, approximately 19,488 more Canadians died between March 2020 and July 2021 than would have been expected.

That’s 5.2 per cent more deaths than if the pandemic never happened.

During that time frame, Statistics Canada says that while 25,465 people died as a direct consequence of contracting the virus, the pandemic also delayed medical procedures and led to a rise in substance use, which could also have contributed to the number of deaths.

On the flip side, some lives may have been spared by other causes, including public health measures that prevented influenza from spreading as usual last year.

The numbers don’t reflect all the deaths that occurred as some are still being investigated, so the data may under-represent the true number of deaths attributed to certain causes, including suicides.

They have also been adjusted to account for changes in the population, such as aging.

The highest number of deaths happened in the spring and autumn of 2020.

There was not a significant number of extra deaths between mid-January 2021 and the end of July 2021, according to the agency, despite the fact that COVID-19 claimed 6,255 lives in Canada during that time.

However, some provinces, including Ontario, Saskatchewan, Alberta and British Columbia, were an exception.

British Columbia and Alberta also saw more people dying than typically expected this past summer when a heat wave settled over both provinces.

Statistics Canada expects to release a more comprehensive picture of how many more people have died as a result of the pandemic by the end of November.

Source: More than 19K Canadian lives ended than if pandemic never happened: Stats Can

#COVID-19: Comparing provinces with other countries 3 November Update

The latest charts, compiled 27 October. Canadians fully vaccinated 75.4 percent, higher than USA 58.7 percent and the UK 68.4 percent).

Vaccinations: Quebec and UK are now ahead of the Canadian North, where few vaccinations took place. Australia now ahead of New York. China fully vaccinated 76.6 percent, India 24.4 percent.

Trendline Charts:

Infections: The chart shows the number of infections in Alberta continues to level off unlike the Prairies or British Columbia.

Deaths: Alberta deaths, along with the Prairies albeit to a lesser extent, continue to climb.

Vaccinations: Alberta vaccinations continue to surpass the Prairies. Immigration source country vaccination rates starting to increase again given India’s acceleration of its vaccination program.

Weekly

Infections: Australia ahead of Atlantic Canada.

Deaths per million: No relative change.

And a good piece on what the UK did wrong (applies to a number of Canadian provinces):

There are downsides to most Covid-19 precautions. Keeping children home from school can cause them to fall behind. Working from home can impede creativity. Staying away from friends and relatives can damage mental health. Wearing masks can muffle speech, hide smiles and fog eyeglasses.

For all of these reasons, the ideal Covid policy for any society balances the benefits and costs of precautions. It acknowledges that excessive caution can do more harm than good. By now, regular readers will recognize the search for Covid balance as a theme of this newsletter. Today, we want to focus on a place that seems to be erring on the side of too little caution: Britain.

Over the past year, Britain’s Covid response has included some major victories. The country rushed to vaccinate people (as we’ve explained) and was also willing to reimpose behavior restrictions last winter. These measures helped cause a sharp drop in caseloads.

In response, Britain reopened over the summer, allowing people to live largely without restrictions. Schools and workplaces have returned to normal, without masks. Restaurants are booked. Finding a taxi on a Saturday night in Central London is again a challenge.

“There’s a feeling that finally we can breathe,” Devi Sridhar, the head of the global public health program at the University of Edinburgh, wrote in August. “We can start trying to get back what we’ve lost.”

The problem is that Britain now seems to have lost a sense of balance, as Sridhar has also suggested. Cases have surged this fall, more so than in the rest of Europe, the U.S. or many other countries. Yet Prime Minister Boris Johnson’s government continues to oppose measures that could reduce cases.

We want to focus on Britain partly because it can offer lessons for the U.S. and other countries. The Delta variant arrived in Britain earlier than in many other places, making it something of a leading indicator. Cases in Britain rose for about two months starting in May and then started falling. But the decline didn’t last:

Over the past week in the U.S., cases have also stopped falling. The reasons are not clear, as is often the case with Covid, and the recent increase is minuscule. But it’s a reminder that the pandemic will probably keep having ups and downs.

Experts say Britain seems to be making three main mistakes that are aggravating the pandemic.

Despite being ahead of most of Europe on vaccinating adults, Britain waited to approve vaccines for adolescents. It did not recommend vaccinating 12- to 15-year-olds until September, weeks after many students had returned to school, as our colleague Josh Holder has noted. Today, only 21 percent of 12- to 15-year-olds in England are vaccinated, compared with 80 percent of adults.

The U.S. faces a related challenge. About 57 percent of Americans age 12 to 15 have been vaccinated, and children 5 to 11 are on the verge of becoming eligible. A significant number of parents remain wary, partly because Covid is rarely severe in children. But vaccinating children — in addition to the individual benefits — is likely to hold down cases for everyone else.

The biggest problem in the U.S. is a vaccination rate lower than in most other high-income countries.

The pace at which vaccines lose their effectiveness remains a subject of intense debate. Most experts believe that the vaccines remain excellent at preventing severe illness, even months after shots are given. But the bulk of the evidence suggests that the vaccines do lose some of their ability to prevent at least mild infections. That’s especially true of the AstraZeneca vaccine, which has been widely used in England.

Britain’s initial speed at vaccinating people brought down caseloads early this year. Yet it also meant that waning immunity became a problem sooner than in countries that were slower to give shots. Britain is now offering boosters to people 50 and above, as well as health care workers and the medically vulnerable.

Over the next few months, waning immunity could become a growing problem in the U.S., especially for more vulnerable people. All Americans 65 and above are eligible for boosters, along with anybody who received the Johnson & Johnson vaccine and some other people.

Behavior restrictions — like mask wearing — are not as effectiveas their proponents sometimes suggest. Britain offers a case study: Scotland, where masks are often mandated, has a similar level of Covid spread as England, where masks are less common, as John Burn-Murdoch of The Financial Times has written. If masks determined Covid spread, Scotland’s rate would be lower than England’s.

But there is a difference between a precaution having a modest effect and no effect. Masks do help, according to a wide variety of evidence, even if their impact is sometimes overwhelmed by other factors. Britain seems to be suffering from a lack of almost any restrictions, including mask mandates. Among the biggest problem, Burn-Murdoch notes, is the number of crowded indoor gatherings across Britain, including Scotland.

When cases are falling, it often makes sense to let people live more freely. When cases are surging, the reverse is true. Britain is ignoring that lesson — and pleas from many experts.

Britain’s recent Covid policy has led to deaths and overwhelmed hospitals. “When a health care system fails, increasing numbers of people suffer and die needlessly,” Dr. Kenneth Baillie wrote on Twitter. “This is happening, now, all over the U.K.”

Still, it is worth putting Britain’s troubles in perspective. The country’s high vaccination rate means that only a tiny share of recent cases have led to severe illness, and the death rate this fall has been a fraction of what it was last winter. “This virus is going to be with us for years, if not the rest of our lives,” Willem van Schaik, a microbiologist at the University of Birmingham in England, told us. “We’ve definitely left the worst behind us.”

Despite the Covid surge in Britain, the U.S. — where the overall vaccination rate is lower — arguably remains in worse shape, with a considerably higher death rate per capita. Why? Vaccination rates still matter more than anything else.

Source: https://www.nytimes.com/2021/11/02/briefing/britain-covid-cases-restrictions.html

#COVID-19: Comparing provinces with other countries 27 October Update

The latest charts, compiled 27 October. Canadians fully vaccinated 74.8 percent, higher than USA 58.1 percent and the UK 68.2 percent).

Vaccinations: Canadian North ahead of Quebec, UK ahead of Canada, Japan ahead of Italy and France, Australia ahead of California. China fully vaccinated 76.4 percent, India 20.6 percent.

Trendline Charts:

Infections: The chart shows the number of infections in Alberta starting to level off unlike the Prairies or British Columbia.

Deaths: Alberta deaths, along with the Prairies albeit to a lesser extent, continue to climb.

Vaccinations: Alberta vaccinations continue to surpass the Prairies. Immigration source country vaccination rates tapering off.

Weekly

Infections: UK ahead of New York.

Deaths per million: Alberta ahead of Ontario.

Useful analysis in the Economist on the effectiveness of vaccine mandates:

In the 24 hours after France announced that it would require proof of vaccination or a negative covid-19 test to enter many public spaces, 1m people signed up for jabs. Other countries are following suit: Italy imposed a vaccine-or-test policy last week.Listen to this story

How effective will such rules be? The response in France was robust, but many of those people might have sought jabs anyway. In American polls, most unvaccinated people say they do not intend to get shots.

Because jabs for covid-19 are new, the impact of mandating them will probably differ from that of requiring children to get well-established vaccines. However, history still offers relevant data on hardline refuseniks’ susceptibility to legal fiat.https://infographics.economist.com/2021/20211023_GDC100_2/index.html

The link between mandates and uptake of standard vaccines in childhood is murky. Much of Europe enjoys broad coverage without mandates, whereas poor countries’ edicts are often honoured in the breach. Even among countries with similar gdp per person, those with mandates do not vaccinate more—perhaps because only places with low uptake resort to coercion.

Another way to assess impact is studying changes over time when new mandates come in. Uganda’s long-run upward trend in jab rates actually flattened out after the country imposed a mandate. However, it only began requiring vaccines once 80% of children were already getting them.

In rich countries mandates have helped a bit. In 2016 Australia ended an exemption for conscientious objectors. Its jab rate for polio rose by three percentage points. After imposing new mandates in 2017-18 following outbreaks of vaccine-preventable diseases, Italy saw gains in measles shots, and France in meningitis-C jabs. In six countries that have stiffened rules since 2000, the average gain was 2.2 percentage points.https://infographics.economist.com/2021/20211023_GDC100_3/index.html

The best evidence that mandates matter comes from America. Some states offer carve-outs from mandates only for medical reasons; others also recognise religious or philosophical ones. After adjusting for demographic and political characteristics that also affect jab rates, uptake in states with the fewest exceptions is 1.1 percentage points higher than in those with the most.

These effects sound small. But since jab rates cannot exceed 100%, mandates can only do so much if uptake is already high. Moreover, for diseases like measles, 95% of people need protection to reach herd immunity. A few percentage points can determine if outbreaks take off or fizzle out.■

Source: https://www.economist.com/graphic-detail/2021/10/23/the-impact-of-vaccine-mandates-is-modest-but-potentially-crucial