There’s been some backlash and disappointment from several groups who thought they would be on the priority list for getting the COVID-19 vaccine, but found out on Feb. 9 that in all but a few cases, the Saskatchewan Health Authority (SHA) would be basing it distribution by age, getting to the oldest people first. But Premier Scott Moe and Chief Medical Health Officer Dr. Saqib Shahab say it comes down to working with a small amount of vaccine and having the most impact with it.
On Feb. 11, New Democratic Leader Ryan Meili told reporters in a Zoom press conference from Saskatoon that health care workers were notified by email on Feb. 10 that those not already listed in the Phase 1 distribution would have to wait with everyone else. The Phase 1 list includes workers with long-term care homes, emergency departments, intensive units and COVID-19 wards.
Meili said, “We've had nearly 1,700 people test positive, health care workers test positive, with COVID-19 here in Saskatchewan every day. These are folks who go to work and they put on PPE (personal protective equipment) they risk their own health in their jobs. And it is so important not just to reflect the value of that work, but also to recognize we need them to stay healthy so that they can help others worse. So this last minute decision to change from the guideline advised set of principles and priorities that this government made, to yank from the SHA into the premier's office, the plan for vaccinations to remove health care workers acting against the national guidelines doesn't make any sense.”
Saskatoon Police Service Chief Troy Cooper, who has personally recovered from COVID-19, tweeted on Feb. 10, “We never wanted to be first, but we do need to be a priority.”
He tweeted he personally wouldn’t receive the vaccine, based on his age, until his frontline members had.
Saskatchewan Union of Nurses president Tracy Zambory said in a post to its members on the union’s website, “I know many SUN members are confused and disappointed by the significant change to Phase 2. We share your disappointment and are very concerned.
She added, “With all that you have faced, you should not have to worry about vaccination rollout too.
“You are essential to the functioning of our health system and to us beating COVID-19 – you must remain a priority in our vaccine rollout plan. Our province should be following evidence, and best practices for vaccination of health workers being employed in Canada, and around the globe. By no longer prioritizing healthcare workers in Phase 2 of Saskatchewan’s vaccination rollout, we are neglecting national standards and the guidelines stipulated by Canada’s National Advisory Committee on Immunizations – the NACI.”
NDP priority list
Asked what priority list the NDP would use, Meili responded, “I actually thought the earlier list from the SHA made a lot more sense,” Meili said, referring to the priority list released to doctors on Jan. 14.
“The concerns being raised by teachers and police and others, those are worth looking at. These are vulnerable groups in their exposure. Having a closer look at the health conditions that would trigger being in a priority group, that's absolutely worth discussing. The case of healthcare workers is open and shut. There is no argument to be made to not include healthcare workers as the priority group. The national guidelines make that very clear. And even that the SHA, their own plan, that was what was in there. It's only when the premier decided to take it over, we went to this irrational approach of not including health care workers as a priority,” Meili said.
“When you're when you're older, you're at higher risk, there's no question. But the health care workers are in risky situations, they're more likely to be exposed to and contract the virus. We have seen health care workers and younger folks die as a result of this virus. They're also going from patient to patient, ward to ward, so there's higher risk of them infecting others, including elderly patients who are at risk. And last, we need them to be healthy. When you have a healthcare worker test positive, well, that might mean them afford for two weeks, and everybody else they've been in contact with for two weeks. You need to keep your health care workers negative when it comes to COVID-19.”
Meili said the decision was a political one. Asked to elaborate, he said, “I think there's a whole lot more people that are 50 to 59 or 60 to 69. Then there are health care workers, and so he's counting the votes, when what he should be doing is acting in the most evidence-based way to keep people safe and keep our healthcare system functioning properly,” referring to Health Minister Paul Merriman.
Meili said, “I don't understand why having fewer vaccines is a reason to do it wrong, to not go about it in the evidence-based guidelines, recommended way of doing it, randomly by age without considering these other factors.”
Moe responds
When asked during the regular COVID-19 briefing at the Legislature in Regina on Feb. 11 if politics and votes were a factor, as alleged by Meili, Moe responded, “They’re wrong. That simply isn’t it.
“No, most certainly, the people in their 60s have poor outcomes if they should contract COVID. The data that we have here, for example, people who are 60 to 79, at Feb. 9, 76 of those have been hospitalized. It’s the largest category, according to Dr. Shahab’s graph here of any other age range.
“We are most certainly making the vaccine available on a priority basis, ensuring that those health care professionals that are at high risk of coming in repeated contact with COVID patients do have access to that vaccine, and they’ve been a priority in Phase 1. We’re doing a re-evaluation of those segments as we speak. But ultimately, at the end of the day, our hospitalizations, as you look at the graph, our fatalities, are largely in the sector that is 60 years and older. So that is a statement that, quite frankly, I wish the NDP wouldn’t of made, and I think they should retract,” Moe said.
Vaccine shortage
Moe pointed out the province is only 10 to 12 per cent through its Phase 1 vaccinations. “This is very, very challenging to disperse what is a very scarce resource and we have a number of people that want to have access to that resource,” he said.
“We're hearing from you know a number of health care workers and I understand why we're hearing from our educators and we're hearing from representatives of our frontline law enforcement officials, and I understand why we're hearing from these from these folks,” Moe said, noting he was familiar with the NACI document. “The Ministry of Health will be having a look at some of the recommendations that were in that document, too, with an eye as to should some of those be pulled forward out of actually what was them I believe a Phase 2 into Phase 1.
Moe said, “But the fact of the matter is that not all health care workers in our public health care system are going to have priority access to this vaccine. I understand why the request is there, and Dr. Shahab had spoken to the risk of exposure earlier. There is a risk of exposure that varies across our health care system. That's one of the factors that needs to be taken into account.
“There also is the risk of a negative outcome when you do contract COVID-19 and that is that is age, yes some small groups that have some ailments, but predominantly age and Dr. Shahab had the charts here that that show that. We need to balance that risk of exposure with the risk of a negative outcome with the capacity of us being able to deliver the numbers of vaccines that we were expecting to receive from the federal government. We're trying to do that as best we can and to keep people safe, and to ensure that we are as quickly as possible, yes, making the vaccine available, and making it available to people that could have a very negative outcome, and also then in balancing that with the integrity of our healthcare system,” Moe said.
Asked about health care workers not being a priority anymore, Shahab said, “I think basically, there's no vaccine, hardly any vaccine, available. And like the premier said, we absolutely need to get long-term care residents, personal care residents throughout the province vaccinated, two doses.”
He noted there are under 10,000 COVID-facing healthcare workers. They started getting vaccinated in mid-December, and will continue to do so. The number of people who provide clinical care are maybe in the 30,000 to 40,000 range.
He said that once people 50 and older are vaccinated in the broader population, “It is obviously very important that essential workers who are at high risk of exposure also get included, either as part of the age-based, or other as other opportunities arise. You know, there may be additional vaccines that are approved, and the vaccine supply may increase through those mechanisms as well.”
Shahab explained that having broad categories, it is easier to identify those eligible, noting they don’t want people being told they don’t meet the criteria. He emphasized age is the biggest risk factor, especially if you have limited supply of the vaccine.
