Deep into the third wave of the COVID-19 pandemic, Canada is racing to catch up with a virus spreading and mutating across the globe at an incredible pace. No longer is the collective goal to “flatten the curve” – this time, armed with vaccines, the aim is to break the chain of infection altogether.
In this three-part series, YFile investigates the COVID-19 vaccine as an injection of hope for recovery. Today, in part three, we look at the road to recovery.
Every year, there are roughly 200 events that have the potential to become a pandemic.
Let that sink in a moment: That means each year, 200 diseases that emerge in different parts of the world are tracked by scientists and public health experts for signs of high transmission, severe outcomes and rapid spread across borders.
While nearly all of these diseases do not go very far, the ones that do start to emerge with concerning traits must be contained before they spread globally, explains Steven J. Hoffman, the Dahdaleh Distinguished Chair in Global Governance and Legal Epidemiology, a professor of global health, law and political science, and the director of the Global Strategy Lab at York University.
With the novel coronavirus SARS-CoV-2, we are well past that point. “Not only do we now have a virus that is in every country in the world, but there is so much of this virus in the world that by random chance and evolutionary pressure we are seeing increasing numbers of mutations,” says Hoffman.
The good news is the COVID-19 vaccines seem to be effective against these variants of concern (VOCs). The bad news? We still could see future mutations that introduce a new threat, even if an entire population is vaccinated.
We might then ask: If we know there is potential for a global pandemic roughly 200 times a year, why weren’t we more prepared for COVID-19 and how did it become so unmanageable? What haven’t we learned from previous pandemics?
Hoffman posed a similar question in 2016 when he published the article “How many people must die from pandemics before the world learns?” to investigate the underlying global institutional failures that allowed the Ebola pandemic to proliferate. He concluded that a death toll of 11,323 was not enough to instigate this change.
“What a tragedy it would be if we need a far worse pandemic than Ebola, one that kills many more people and wreaks even greater havoc, to finally motivate the global institutional changes that are urgently required,” the 2016 article reads.
Yet, here we are.
“The article concludes with the idea that, given how global politics work, a whole lot more people are going to need to die before the world treats pandemics seriously,” he says. “There has been so much suffering for everyone during this pandemic that if COVID-19 doesn’t trigger the kind of changes we need, I don’t know what will.”
Changes, he says, to the underlying inequities and problems that exist in society and around the world that demonstrate how poorly prepared we are for these types of transnational threats that have the power to shape the future.
“I am genuinely hopeful, however, and I think there are a lot of people who feel like that – that this is the time to make these changes,” says Hoffman. “I hope it’s a recovery and that it’s a good recovery.”
Vaccination, he says, is one element of the recovery that will benefit not just individuals, but families and communities. The more people with COVID-19, the worse it is for everyone: hospitals overwhelmed, businesses closed, livelihoods at risk, children learning remotely.
“In that respect,” he says, “vaccinations are good for individual health but also equally or even more important for communities.”
But there is more to consider.
Planning for a potential fourth wave of COVID-19 – and possibly a fifth and sixth wave and so on – relies on more than vaccination campaigns, says Eric Kennedy, assistant professor at York University in the Disaster and Emergency Management program. Breaking the chain of infection is a global issue that requires collaborative solutions.
Kennedy notes two paradigms that have emerged in response to the global spread of COVID-19 since it emerged in March 2020: one perspective is to shut down the country’s borders, prevent foreigners from coming in and on-shore production of vaccines, personal protective equipment and resources to keep the virus out; the other perspective is to position public health as a “team sport” and participate in collaborative, international networks and respond with a global lens.
The latter is the approach Canada has taken.
“I think the fourth wave and onward waves come from the potential of the virus to mutate, and when we have unconstrained outbreaks in the world – especially in places where vaccination rates are low – we are giving the virus the chance to mutate and change,” says Kennedy.
The strategy to encapsulate a country and “go it alone” therefore cannot keep you safe, he says, because it creates potential for outbreaks and mutations in other parts of the world. Closing borders to keep the virus out isn’t sustainable over a long period, and mutations will eventually find a way in.
“We need to get COVID-19 under control around the world, reduce the opportunity for the virus to mutate and change, and slow the pace at which that happens so our vaccines can stabilize around it,” he says, adding this will be the determinant of future waves.
Kennedy is leading a project conducting surveys and interviews to understand social experiences, attitudes and perspectives, and adaptations regarding the COVID-19 outbreak in Canada. This work aims to inform policy through a better understanding of concerns and expectations. One of the key findings to date is the need to approach vaccination with a trust-building dialogue rather than a deficit model correction.
“The deficit model can be very seductive: the simplistic belief that if we simply share facts with the public, they’ll be eager to get vaccinated,” Kennedy warns. “But what we’ve found is that people have all sorts of very detailed and nuanced questions. The way to resolve this isn’t to bombard them with more public service announcements but to take these concerns seriously … and give really good answers that are evidence-based,” he says.
Factors affecting decision-making around vaccination, he says, have been consistent through these inquiries: people want evidence and advice from medical doctors.
Hoffman, who led the development of the UN Research Roadmap for the COVID-19 Recovery, says science is the way out of this pandemic.
“Science is the way we are going to ensure that next year we do things better than this year, and it is science that is allowing us to do better this year than last year,” says Hoffman. “This is the way we are going to make a better society in the future.
“I think what’s clear is that science is the way out of this pandemic. Science is also the way out of other global challenges we are going to face in the future, and we need everyone to be champions for science.”
If science is the answer, what will be the catalyst for recovery?
Kennedy suggests one opportunity is to use vaccination targets as a type of “social contract” to motivate a return to normal – much like Ontario has recently announced, simply with higher targets.
“I want to be clear that in no way do I expect the vaccine is going to solve this perfectly, but the vaccine will get us to a point where we are not dealing with severe illness and overwhelmed hospitals,” he says.
“I do expect that widespread vaccination and declining case rates will bring a little bit of a bookend to this.”
This concludes YFile's three-part series. For previous stories, visit yfile.news.yorku.ca/2021/06/09/an-injection-of-hope-herd-immunity-where-are-we-now and yfile.news.yorku.ca/2021/06/13/an-injection-of-hope-what-we-learned-from-the-vaccine-rollout.
By Ashley Goodfellow Craig, deputy editor, YFile