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A quicker path to normal: U.K. reopens at 30% vaccinated while Canada waits for 75%

The 75 per cent fully vaccinated threshold is based on population modelling ‘with lots of different parameters and assumptions to fill in,’ Dr. Theresa Tam said

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Across the United Kingdom, where 30 per cent of the population is fully vaccinated against COVID-19, people are free to begin “cuddling cautiously,” pubs are reopening and millions are socializing again as the country further exits a grim four-month lockdown.

In the U.S., the Centers for Disease Control and Prevention has said the fully vaccinated, roughly 37 per cent of Americans as of Monday, may, with some exceptions, safely drop their masks, stop distancing and gather inside with people with whom they do not live. Fans are distancing at baseball stadiums, Broadway is set for a September reopening and county fairs across New York State are set to resume this summer.

Canadians, meanwhile, have been told they can look forward to a similar taste of pre-COVID life, though not until 75 per cent of those eligible for vaccines have achieved full vaccination status, meaning two weeks after the final vaccine dose. As of Monday, that figure stood at less than four per cent.

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The 75 per cent target is part of “Life after Vaccination” guidance issued by the Public Health Agency of Canada on Friday, a “roadmap,” as Health Minister Patty Hajdu described it, that some critics say is so scant on detail it could have been sketched out on the back of a cocktail napkin. Others are asking why Canada’s target is so much higher than in other countries.

The guidance came days after Prime Minister Justin Trudeau’s confusing “one-dose summer, two-dose fall” messaging. While it might sound catchy “in a weird way,” trying to explain complex problems in a simple slogan can be problematic, says Dr. Gerald Evans, chair of the division of infectious diseases at Queen’s University in Kingston, Ont.

A “one-dose” summer, according to the health agency, in fact doesn’t look much different than last summer with no vaccines, with only camping, hiking, patio dining and small, outdoor picnics in the offing, provided 75 per cent of eligible Canadians have received one dose, and 20 per cent of them a second.

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Come fall, if cases are low and two-dose vaccination is high, “then (the government’s emphasis in bold) local public health will be able to lift more measures and you should be able to do more activities indoors with people outside your household,” the public health agency wrote, like attending “colleges, indoor sports, family gatherings.”

Still, restrictions fall squarely in provincial jurisdiction, and the provinces and territories can choose to ignore Ottawa’s bare-bones guidelines.

According to the data Evans has seen, “if we had about 80 per cent of the population with two doses of vaccine into them by September first, we would have virtually a normal looking fall.”

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Several provinces are already promising better. Saskatchewan plans to have second doses available to everyone by sometime in mid-July, while Ontario “will work our backs off to have a two dose summer,” Ontario Premier Doug Ford said Friday.

The 75 per cent fully vaccinated threshold is based on modelling projections “with lots of different parameters and assumptions to fill in,” Canada’s chief public health officer, Dr. Theresa Tam, said Friday.

“But I think having an aspirational target is really a good thing for everyone to aim for,” she said. The U.K., hit with a devastating third wave, “crushed that curve, that very massive third wave, to very low levels by the time they got to that kind of vaccine coverage.” Canada, by comparison, is just beginning to peak in many provinces and territories, Tam said.

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What’s different about this summer, Tam offered, is that one shot of a COVID-19 vaccine should make people feel more confident that they’re better protected, though “you’ve got to get that second dose to provide maximal protection.”

A quicker path to normal: U.K. reopens at 30% vaccinated while Canada waits for 75%

But the lack of clarity has some people attempting their own back-of-the-envelope calculations.

“One I’ve heard a few times already runs like this: ‘Wait a minute. These are the overall thresholds. Can I create a slightly larger ‘bubble’ of trusted family members and friends from two or three households who’ve all had 1 or 2 shots and have minimal outside exposure? Isn’t that equivalent to 100% coverage,’” Dr. David Naylor, co-chair of Canada’s COVID-19 immunity task force, said in an email.

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“Those types of questions need to be answered sooner rather than later,” Naylor said.

There is worry now over the infectiousness of the B.1.617 variant that first emerged in India, but the two mRNA vaccines — Pfizer-BioNTech and Moderna — seem to offer reasonable protection, Naylor said.

“So the key is to vaccinate as many Canadians as fast as possible,” he said, including catching up with a higher proportion of second doses, “even as we race ahead with first doses,” to chase that 75 per cent threshold for total population coverage.

If restrictions are abandoned entirely before reaching that target, the incentive to get vaccinated may diminish. The U.S. is already butting up against vaccine hesitancy. The number of Americans seeking to be vaccinated dropped by a third in recent weeks, Reuters reports, prompting companies and health authorities to offer booze, baseball tickets and other freebies to persuade people to get their shots.

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The U.K. had a raging epidemic, which Canada avoided, before it began vaccinating. “We had a much smaller epidemic. So there are a larger number of people in the U.K. who achieved immunity through natural infection,” said University of Ottawa health policy expert Amir Attaran. There is some preliminary evidence from several small studies that a single jab of the Pfizer of Moderna vaccine can launch a rapid immune response in the previously infected.

“In Canada — and this is the good news — rather few people compared to the U.K. achieved immunity through natural infection, so if anything we must outdo the vaccination performance of the U.K. to be in the same place,” Attaran said.

Likewise, the U.S. had a “raging (former U.S. President Donald) Trump epidemic, such that the first dose that many people have received is actually, functionally, more like their second,” he said.

“It’s all about the dual attack mode,” Evans said. “Vaccinate the living daylights out of the population and drive those numbers down and don’t re-emerge from the restrictions until those numbers have dropped to a point where public health says, ‘no problem, we’ve got this under control, we can handle it from here with our outbreak management.’”

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