Leslie McGill, President & CEO, MedicAlert Foundation Canada
Canada’s vaccine rollout has been a pendulum oscillating from one extreme to another – an exercise which has left Canadians feeling weighed down by a healthcare system that is less than the pride and joy we’ve touted it as for decades. With the country coming out of another lockdown after enduring a second wave of COVID-19, I’m left disappointed that our most vulnerable populations are still questioning as to when they’ll be vaccinated. How is this our reality? Our universal healthcare model isn’t universal. The vaccine rollout is a stark reminder that our system is tiered, outdated and mired by racial, economic, gender and age inequities. It’s a headshake and a growing example for other countries of what not to do in a pandemic. To say that Canada’s vaccine rollout has been suboptimal is an understatement.
Amid the early questions about when and where the vaccine would be made available, it was a relief to hear that frontline healthcare workers and those living in long-term care facilities would be the first to receive the Pfizer and Moderna vaccines. The news provided a sense of relief that although Canadian vaccine manufacturing was decimated decades ago, and our ability to access the global pharmaceutical supply chain has long been fraught with challenges, at least some our most vulnerable populations would soon be protected.
No one argued against this strategy. The horror of the virus against those living in long-term care facilities had been documented across our news channels. We saw the wear and tear on the faces of our frontline healthcare teams – yes, let’s vaccinate these segments! But something that was so black and white in its undertaking became grey rather quickly, as we’ve begun to see reports of just who is being vaccinated. Leniency in how we coined and defined frontline healthcare workers became more and more apparent as vaccines became more and more available.
How do hospital personnel with no patient contact get vaccinated ahead of frontline healthcare professionals as our COVID-19 cases soar? How do healthy family members of patients in long-term care facilities get vaccinated before frontline workers?
If Canada isn’t vaccinating anywhere near the level of our global counterparts – and if our Tommy Douglas national pride allows us to rank 38th globally in terms of the number of administered doses per capita, then how can we confidently roll out a vaccine program across the country? Can we afford to align on uniformity of who gets it? Our recent history says no. Can population health data be the primary driver of vaccine decision-making across individual provinces? What thresholds are in place to ensure the right people are getting vaccinated at the front of the line?
From my experience of consulting during the SARS pandemic, 35 years of working in the healthcare system, and now at the helm of MedicAlert Foundation Canada, the one organization whose job is to help protect individual Canadians at a time of health crisis, there is one thing that could be standardized across the country to help support our decision-making regarding who gets it, and when and where.
Throughout the pandemic, we’ve heard the term vulnerable people used in a variety of contexts. That said, there is no standard national definition for what constitutes a vulnerable person – does the term begin with health, or socio-economic realities? From MedicAlert’s perspective, until a single national definition of health vulnerability is established, we will continue to see inequities and inequalities in the way care is managed during high-risk situations.
MedicAlert houses and maintains the National Wandering Registry which helps tens of thousands of Canadians who are at risk of wandering. Our work with the first-responder and health professional communities has given rise for the need to broaden our registry capacity to provide a central resource of information that can easily support the needs of frontline workers whose job it is to protect and care for our most vulnerable populations.
Social determinants of health needs to be less of an academic exercise to label the “have-nots” within our communities, and more of a term that can offer us a foundation towards real action to assist our most vulnerable peoples across the country. A national registry with a uniform definition of what it means to be a vulnerable person – via social determinants of health – can allow us a uniform benchmark to help address who are our most vulnerable populations no matter the situation.