The AZ Vaccine And The Rare But Serious Clotting Disorder.

TheCautionFlagIs

OutVille

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Update IV, Sat April 10th: The paper, mentioned as a pre-print in the original post, from the German group that originally described the issue has now been peer-reviewed and published in the New England Journal of Medicine...Here....A companion paper that comes, essentially, to the same conclusions from a Norwegian group is...Here.

Update III, Wed April 7th...The European Medicines Agency has provided an update, supported by data from the UK and concludes that this is a rare adverse event...We discuss this update...Here.

Update II, Wed Mar 31st...BC is now offering AZ Vaccine to folks 55-65 in the Lower Mainland due to the high rates of viral infection in the region...Announcement is here....Pharmacies to contact are here...I'm in the age group and will be getting the vaccine...The syndrome described below is  very rare and there is now a protocol to treat it if it does occur.

Update I, Tues March 30th, at bottom of post

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On Saturday March 27th the top of the ladder journal Science published an information piece (i.e. not a primary data paper) on the rare but serious cases of blood clotting/thromboses with platelet problems in folks who have received the AstraZeneca COVID-19 vaccine. 

The piece was written by contributors Kai Kupferschmidt and Gretchen Vogel and it is good.

One of the issues is the differing incidence rates in various jurisdictions including...

The UK:

...The United Kingdom has officially reported only 5 cases—despite administering 11 million doses of the AstraZeneca vaccine...

Compared to, for example, Norway:

...Norway, which has administered the AstraZeneca vaccine to 130,000 people under 65, has reported five patients who had low platelets, hemorrhage, and widespread thromboses, three of whom died...


Why the difference?

Well, one possible explanation is the way the vaccine was initially used in continental Europe compared to the UK:

...So far, most cases have been observed in women under 65. But that could be because of the vaccinated population: Many countries initially used AstraZeneca only in people under 65 because early clinical trials included few older recipients. That meant the vaccine was used in priority groups such as health care workers and teachers, a majority of whom are women. In Norway, for example, 78% of the AstraZeneca doses went to women, says Sara Viksmoen Watle, chief physician at the Norway Institute of Public Health. The United Kingdom, however, used the vaccine first in older people, which may explain why fewer unusual clotting events have been spotted there...


So, can this problem be dealt with?

Well, there is a group in Germany led by a researcher named Andreas Greinacher that is calling the syndrome 'vaccine-induced prothrombotic immune thrombocytopenia' (VPIT). They think that VIPIT has similarities to another rare condition called 'heparin-induced thrmobmocytopenia' (HIT) that is caused when the body makes its own antibodies against a complex of the blood thinner heparin and a factor called PF4  that causes massive platelet activation and thus clotting. Greinacher says that VPIT can be diagnosed and treated in a manner similar to the way that HIT is dealt with:

...Greinacher agrees on the need for more data. But he says it's crucial to alert doctors to the potential complication. When recognized in time, HIT can be treated with immunoglobulins—nonspecific antibodies from blood donors—that help put the brakes on platelet activation. Non-heparin blood thinners can help dissolve the clots. VIPIT should be treated in a similar way, he says. In at least one case, Greinacher says, a doctor sought the group’s advice and the patient recovered...


The work of the German group has not yet been peer-reviewed, but they have placed the data on a public pre-print server so that it can be scrutinized by experts in the field. And, at the very least, the British Society for Hematology and the German Society for the Study of Thombosis and Hemostasis (of which Dr. Greinarcher is a member) are taking the matter very seriously and issuing guidelines for monitoring and potentially treating the issue. In addition, the European Medicines Agency is having a very close look at all the data and it is expected to report on the matter next week (Apr 6-9th). 

Given all this a number of jurisdictions have put age restrictions on the AZ vaccine:

...Many countries are, for now, accepting the risk that the AstraZeneca may carry, but several have restricted its use to people who are at the highest risk of dying from COVID-19: those aged 55 or older in France, 65 or older in Sweden and Finland, and 70 or older in Iceland...


It would appear that Canada's decision to do the same, despite the fact that no cases this disorder have yet been detected after the administration of 300,000 doses of the AZ vaccine nationally, is, at least for the moment, a prudent one, particularly given that we have other vaccines at hand.

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The National Advisory Committee on Immunization (NACI) recommendation and rationale is...Here.

The Ontario Science Table's COVID-19 Response website also has an excellent primer on VPIT....Here.

Apologies for being mostly offline as this and the variant growth has been unfolding locally but it's grant writing season for me which has curtailed my reading on all things COVID somewhat for the last couple of weeks or so.

Update, Tues Mar 30th: Kai Kupferschmidt, one of the co-authors of the piece quoted above, reports on Germany's updated numbers... 2.7 million AZ vaccine doses administered, 31 cases of cerebral venous thromboses (29 in women age 20-63), 19 with thrombocytopenia...This is likely a considerably higher rate than would be seen in the population.

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And So It Begins...

OhWoeAre
TheeVille


Following up on the good Mr. O'Toole's inability to yank the base toward a faux center last weekend, the self-proclaimed head trainer has grabbed hold of the leash and is attempting to lead the pack back to an old familiar kennel...

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Tip O' The Toque to Alison of Creekside.

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Erin O'Toole Learns That The Conservative Party Of Canada Is Full Of Conservatives.

RunRunRunRunRunRun

AwayVille

Mr. O'Toole, the man who would like Canadians to believe that he and his will meet them 'in the middle' during the next federal election campaign, made his case to the CPC faithful at their convention earlier today as reported by John Paul Tasker of the CBC:

...O'Toole told delegates the party "cannot ignore the reality of climate change" and that the debate "is over."

"We must also recognize that Canadians expect us to have a real plan for the environment. We need to boldly reclaim the environment as an area where Conservatives are leaders," he said.

O'Toole also said he doesn't want Conservative candidates to be branded as "climate change deniers" in the next election campaign...


A few hours later a majority of the faithful told O'Toole where to go:

...Conservative delegates at the party's policy convention have voted to reject adding green-friendly statements to the policy book — including a line that would have stated the party believes "climate change is real" and is "willing to act."...

{snip}

...Delegates issued a rebuke to climate-minded Conservatives and rejected the policy shift by a margin of 54 per cent to 46...


This could get interesting.

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SubHeader Earworm rising?....This.

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Vaccines....Doing That Thing They Do.

The above is from New Brunswick cartoonist Dawny Mock.

It went, pun intended, 'viral' recently thanks to the Canadian Medical Association.




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Header-induced earworm wriggling?...There is the fauxish original and there is the Billy Joe's no idiot version.

British Columbia's vaccine rollout update is...Here....Big news is announcement of frontline workers in April, but there are timeline move-ups for Phase 3 (clinically vulnerable and age 60-79) and Phase 4 (age 18-59)



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A Great COVID Vaccination Story From The CBC's 'Roving Reporter' In Ontario...

Link

You can listen to Haydn Watters' CBC radio report about 104 year old Patricia McSwain....Here (scroll down).

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Meanwhile, here in British Columbia we're moved things up a little bit for those 80, plus, to make appointments to get their first vaccine dose.

The details of where to call or make your appointment online if you are in Fraser Health are...Here.

Again, remember, elderly folks are only getting the Pfizer or Moderna mRNA vaccines as part of 'Phase 2'. Thus, do not be concerned about the safety issue that has recently been raised about the AstraZeneca vaccine (see footnotes, below). 

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As we've noted before, now is not the time to let down your guard regarding viral transmission. 

We also noted that double masking has been shown to increase the barrier to aerosols both for the transmitter and the receiver....The NY Times has a great video of how best to double mask...Here.

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Regarding the AstraZeneca, adenovirus-based vaccine that has been rolled out heavily in the UK, last week we noted that the flagging of a small number of time-associated blood clotting events in Europe was likely soon to become an issue in some jurisdictions. Clearly, that has come to pass with all kinds of points of view being expressed on numerous fronts. Derek Lowe, whose analysis is always critical but data-based and fair, weighs in on the details of this and some comparative efficacy concerns...Here. The safety issue that needs to be resolved is whether or not these events have occurred at a greater frequency than in the same cohort of the population that has not yet been vaccinated. While Britain has crunched its data and has come to the conclusion that the number of clotting events time-associated vaccine administration are not greater than those in the population, other jurisdictions in Europe have not done so, especially when it comes to a small number of serious cerebral sinus thrombosis events as has been documented in Germany...The follow-up issue that will need to be addressed, if there an increase in incidence, will be to determine the mechanistic cause of it.
As alluded to above, there is another potential concern with the AZ vaccine that involves efficacy rather than safety, specifically as it pertains to protection against the South African viral variant (B.1.351). We previously noted that concerns were raised that the COVID-19 vaccines might be less effective against the South African variant based on laboratory results that showed a somewhat decreased ability of recipients of the vaccines to generate antibodies that neutralize that form of the virus...Follow-up laboratory and clinical trial data have now been published in the New England Journal of Medicine that the AZ vaccine also shows a decreased ability to generate neutralizing antibodies against the variant as well as a decreased ability to protect against the onset of mild to moderate disease after infection with the South African variant...A caveat here is the relatively small sample size of the trial which resulted in very wide 95% confidence intervals...As for here in British Columbia, the documented number of South African variant infections is still low - all the more reason to double-mask up and keep on social distancing....

And don't forget that it is the more prevalent  B.117/UK variant that is most worrisome locally at the moment due to its increased transmissibility together with its ability to cause a small but significant increase in mortality Importantly, the UK variant is well whacked by all the approved vaccines...Sure hope I've dealt with reader Booey's concerns here.

Update, Thurs March 18th: The European Medicines Agency, has ruled the AZ vaccine beneficial with no increase in the overall risk of blood clots; however, they do state that administration of the vaccine may be associated with very rare cases of clotting associated with thrombocytopenia (low platelet levels) that can contribute to rare cases of clots in vessels draining the brain (i.e. the cerebral sinus thrombosis mentioned above).

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A Potential Case Of Future Post-Vaccine (Musical) Envy...

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AllThePostPandemicWorld'sA

StageVille


Yesterday, we brought up the reason why there is absolutely no reason to have vaccine envy given that the only way for things to work is for everyone to get jabbed. Thus, the most vulnerable among us should go first.

But...

I sure am envious of the folks who received an impromptu age appropriate post-jab concert in Berkshire, Mass the other day:

After Yo-Yo Ma received his second jab of a COVID-19 vaccine at Berkshire Community College Saturday, he transformed his 15-minute observation period into a concert for the newly inoculated.

The world-famous cellist and part-time Berkshires resident completed his vaccination course at the field house clinic, and he “wanted to give something back,” Richard Hall of the Berkshire COVID-19 Vaccine Collaborative told The Eagle.

Yo-Yo Ma took a seat along the wall of the observation area, masked and socially distanced away from the others.

He went on to pass 15 minutes in observation playing cello for an applauding audience, in what Hall called a “very special” concert that capped the day’s vaccination event...

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So, who in your age appropriate group  that just might be in youor town when the time comes would you like to see set up shop to serenade you after you get jabbed on down the line.

Me, for Lotuslandian fellow travellers of a certain age bracket, I'm thinking of maybe The Pointed Sticks.



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There Ain't No Vaccine Envy 'Round Here.

AllForOne
AndAllVille


Ian Brown had an opinion piece the Globe and Mail on the weekend about 'vaccine envy'.

It was one of those 'Why is she getting jabbed when I'm not?!' kind of deals that, while somewhat tongue-in-cheek, ultimately led to the following at the top of the third act:

The alternative – waiting your turn – can feel like impotence.

Personally, I honestly do not feel that way at all as this thing only works for everyone when everyone gets jabbed, which is precisely what the plan is.

Meanwhile, I'm perfectly willing to wait for those more at risk to go first, and that includes front line folks and people living in Prince Rupert when there is a risk-based rationale.

And, regardless, supply is ramping up rapidly

OK?

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Our 'Other' Public Health Emergency.

The graph, above, is from a presentation made by our provincial health officer on Thursday, March 11th.

It shows the top 15 causes of death in British Columbia in 2020.

Clearly, while a terrible tragedy in terms of absolute numbers, in terms of the percentage/rate of deaths  we have done reasonably well in dealing with the COVID19 health emergency (green bars) compared to many other jurisdictions (scroll down to 'deaths per million residents').

However, take a look at those blue bars in the graph.

They represent the mortality statistics from our other public health emergency

And, unfortunately, it is a longterm, ongoing emergency that keeps getting worse. There is also no vaccine to make it magically end.

There is, however, a way to decrease the deaths substantially and that is something called 'safe supply' so that folks don't inadvertently take bad stuff, stuff like fentanyl mixed with benzodiazepines.

The current provincial government took the first few steps to make a safe supply a reality a few months ago, but things seem to have stalled.

As reported by the Tyee's Andrew MacLeod, Green Party MLA Adam Olsen raised the matter in the legislature this week:


...B.C. provincial health officer Dr. Bonnie Henry issued a public health order in September that allowed registered nurses and psychiatric nurses to prescribe pharmaceutical alternatives to street drugs.

But five months later, that health order has still not been put into action, and Olsen pointed out that over 700 people have died since the order was put in place.

While 30 nurses have been trained to prescribe Suboxone, an opioid replacement medication, critics say that falls short of true safer supply, which would provide pharmaceutical-grade versions of illicit substances instead of alternatives....



Clearly our PHO wants true safe supply to become a reality and, increasingly, so do law enforcement officials.

Which means we've got to get our elected officials at all levels to take things over the finish line.

OK?

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Thanks to reader e.a.f. for prodding me forward on this one.

Tip O' The Toque to independent ledge reporter Shannon Waters for flagging the graph on her Twittmachine feed and digging up the origin doc. 



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Around The Bloggodome...

IfWilliamKristolFlewInToday

They'dSendALimousineAnywayVille


Notable new stuff from folks whose stuff pops up over on the left sidebar BlogCrawl...


City Duo - A great local blog written by a tag-team that works tirelessly to keep us informed about what's going on with development projects in throughout Lotusland. It's the kind of stuff that people like Stephen Quinn used to do back when he was a real reporter. Thus it is a great example of how citizen journalism, when done well, can fill the gaping holes in local reporting that have been dug during the hollowing out of proMedia shops everywhere. This week the Duo fills us in on the 'backlash' potential for development plans in Langara (very low), Granville St. downtown (moderate potential) and the East Fraser Lands/River District (very low).


In-Sights - On the provincial scene, no one digs into the data, financial and otherwise, like Norm Farrell. As you might expect, this weeks he's all over the Site C issue. Norm is fearless about this stuff and will call out everyone who the data are telling him are contributing to a problem that is going to cost us all in the end and that includes both the current government and Hydro. He also provides context with a capsule history of the life of the project.

Driftglass - This is a guy who literally lives in a cornfield in FlyoverVille USA who, along with his partner, has a great weekly progressive podcast that mixes the personal with the political. Drifty was once a prolific commenter at  the late, great Steve Gilliard's blog before the proprietor kicked him out of the nest and told him to go out and set up his own shop which he did more than fifteen years ago. Recently, Mr. Glass was thrown into Twitter jail, (apparently) permanently, for rolling truth tires in front of stupid trains which actually turns out to be a good thing for those who appreciate long form takes on how the modern Republican party is now and always has been full of Republicans. This week, Driftglass takes aim at that 'other' NeverTrump grift that is bamboozling 'Can't we all just get along?' USian liberals, The Bulwark.

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If you are looking for all the actual changes to the COVID-19 proncine-wide restrictions in B.C. announced by B. Henry yesterday, they are....here.

Thanks very much to an Anon-O-Mouse in the comment thread to yesterday's post on Seattle's handling of the pandemic...They pointed out that Kingston, Ontario has also done a great job, in large part, it would appear because the citizenry has consistently and collectively followed the public health rules and restrictions (paywalled TorStar story is here; less informative Global story is here). 



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The Treasure That Is...KEXP.

GoodIs
BetterVille


KEXP is the public radio 'indie' music station in Seattle.

It started out as a campus radio station at the University of Washington and it still has some of that esthetic, especially the part about DJ's programming their own music. They also do a heckuva job of running live shows and informative interviews, even during the pandemic.

Here are two of those show/interview hybrids carried out recently with two of my new favourites, thanks in part to littler. e...

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Seattle's Response To The Pandemic.

EmeraldIsAs
EmeraldDoesVille


The New York Times has an interesting story up by Mike Baker (who is a great follow on the Twittmachine by the way) about Seattle's response to the pandemic.

The whole thing is worth reading but here is the kicker:

...One year later, the Seattle area has the lowest death rate of the 20 largest metropolitan regions in the country. If the rest of the United States had kept pace with Seattle, the nation could have avoided more than 300,000 coronavirus deaths.

During a year in which the White House downplayed the virus and other political leaders clashed over how to contain it, Seattle’s success illustrates the value of unified and timely strategies: Although the region’s public health experts and politicians grappled behind the scenes about how to best manage the virus, they came together to present a united front to the public. And the public largely complied...


It's quite an amazing story, especially given how hard the city and region were hit in the early stages of the pandemic. 

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In other pandemic news....

In a follow-up to yesterday's post, there is a new peer reviewed report out in Nature that shows that the Pfizer vaccine is working well against the UK variant, although things get a little dicey when an additional critical mutation added to the mix....

Delivery of the AstraZeneca vaccine has been halted for the moment in Denmark because blood clot formation has been temporally associated with vaccine administration in a small number of cases. The European Medicine Agency is investigating but it has issued a statement that, at this point, no causal link has been identified:

...There is currently no indication that (AstraZeneca) vaccination has caused these (thromboembolic) conditions, which are not listed as side effects with this vaccine...

{snip}

...The number of thromboembolic events in vaccinated people is no higher than the number seen in the general population. As of 10 March 2021, 30 cases1 of thromboembolic events had been reported among close to 5 million people vaccinated with COVID-19 Vaccine AstraZeneca in the European Economic Area...

Additionally, according to the NY Times, approximately 10 million doses of the vaccine have been administered in Britain without any indication of this problem from health authorities. 

I'm noting this issue here not to be alarmist, but instead to alert you all to the possibility that it could become a talking point locally in British Columbia as we make plans to administer the newly arrived AZ vaccine to front line workers.

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In other local non-pandemic news...

As we kinda/sorta discussed already, it really does appear that Ian Mulgrew of the VSun has a hate-on, which now seems to be bordering on the ideological, for any and all efforts to seriously deal with the money laundering matter in Lotusland...

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The Details On B.C.'s Vaccine Rollout.

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Update: Tuesday March 10th - The date for making appointments for folks 85 and up has moved up to Wednesday March 11th (from Mon Mar 15th)

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The age-based vaccine rollout in British Columbia has begun.

For this phase of the rollout, here's what you need to know if you are age 80 and higher:

Dates:

Call your health authority beginning on the dates below; appointments for jabbing start the following week):

• March 8, 2021: Seniors born in or before 1931 (90 years+) and Indigenous people born in or before 1956 (65 years+) may call to book their vaccine appointment;
• March 11, 2021: Seniors born in or before 1936 (85 years+) may call to book their vaccine appointment; and
• March 22, 2021: Seniors born in or before 1941 (80 years+) may call to book their vaccine appointment.

Where to call (7am to 7pm seven days a week):

Fraser Health: 1-855-755-2455 (and online...here)
Interior Health: 1-877-740-7747
Island Health: 1-833-348-4787
Northern Health: 1-844-255-7555
Vancouver Coastal Health: 1-877-587-5767

What you will need when you call:

-first and last name, date of birth, postal code

-Personal health number (it's on your care card, driver's licence, and/or your BC services card

Where you will go to get the vaccine - one of the immunization clinics in your area listed at the links below:

Fraser Health

Interior Health 

Island Health

Northern Health

Vancouver Coastal Health

What vaccine will you get: 

As part of this phase of the rollout (i.e. Phase 2), despite Harvey O's scaremongering, you will get either the Pfizer or Moderna mRNA vaccine.

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If all this is just too much and/or driving you bonkers, you can have someone make the call for you to set up your appointment - this is what sons, daughters, grandkids and/or neighbours are for!

Don't believe me?...All the info you need is...Here.

(and if I missed something and/or got something wrong, I'm pretty darned sure longtime reader NVG will let us know)


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Mortality And The U.K. Variant - The Headlines And The Data.

There is a new study out in the British Medical Journal that compares the mortality of folks who were infected either with the 'classic' versions of the SARS-CoV-2 virus or the U.K. variant.

Here is the lede from one of the less sensational news reports by Thomson Reuters posted by CBC News:

A highly infectious variant of the novel coronavirus that has spread around the world since it was first discovered in Britain late last year is between 30 per cent and 100 per cent more deadly than previous dominant variants, researchers said on Wednesday.

In a study that compared death rates among people in Britain infected with the new SARS-CoV-2 variant — known as B117 — against those infected with other variants of the COVID-19-causing virus, scientists said the new variant's mortality rate was "significantly higher."

The B117 variant was first detected in Britain in September 2020, and has since also been found in more than 100 other countries...

Here are the actual results and conclusions from the abstract of the paper itself:

Results: The mortality hazard ratio associated with infection with VOC-202012/1 (B.1.1.7/U.K. variant) compared with infection with previously circulating variants was 1.64 (95% confidence interval 1.32 to 2.04) in patients who tested positive for covid-19 in the community. In this comparatively low risk group, this represents an increase in deaths from 2.5 to 4.1 per 1000 detected cases.

Conclusions: The probability that the risk of mortality is increased by infection with VOC-202012/01 is high. If this finding is generalisable to other populations, infection with VOC-202012/1 has the potential to cause substantial additional mortality compared with previously circulating variants. Healthcare capacity planning and national and international control policies are all impacted by this finding, with increased mortality lending weight to the argument that further coordinated and stringent measures are justified to reduce deaths from SARS-CoV-2.

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So.

In addition to the already established increase in infectivity the UK variant increases the risk of dying, at least within the study groups compaared here. 

This study was done in the community not hospitals (where infected folks tend to be sicker and older). Thus,  the overall mortality rate is quite low. Specifically, it goes from 0.25% in the case of the classic virus infection and 0.41% in the case of the variant infection. Regardless the low overall rates, the mortality rate increase in the case of variant infections is statistically significant.

The British research group that carried out the study did their best to rule out confounding variables by 'matching' subjects according to things like age, sex, ethnicity, date of sampling and health authority region. In other words, they did their best to make sure they were looking primarily at  changes that were due to the different strains of the virus and not other factors. 

However, there were at least two factors that they realized they had not ruled out entirely.

One factor was the level of viral infectivity of the two groups. In fact, those infected by the variant did appear to have higher viral loads. However, the researchers concluded that this increase in load didn't likely explain their overall findings.

Another factor was the possibility that those infected with the variant were actually farther along in the course of the disease when they got tested which would affect the mortality numbers given that they used a 28 days after the first positive test result as their study endpoint.

Regardless, the UK variant is now likely doubly concerning as its numbers rise in Canada. Despite this, an important thing to remember is that, as we've discussed before, the approved vaccines show good efficacy against this variant. And, obviously, continued strong public health measures and vaccines will be doubly, if not more so, protective against the variant.

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On a somewhat related note, I don't know about you but I find the screaming local headlines about how some folks have tested positive in some longterm care facilities where the bulk of the residents have already been vaccinated deeply distressing given that  the initial clinical trials was designed to assess  outcomes not viral infectivity. Furthermore, as we've also discussed previously, while there are now some data that suggest that the vaccines likely decrease infectivity/transmission  it is not going to be 100%.  

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What Happens When Identity Trumps All?

TheGilliard

DoctrineVille


So, what's up with the government mandated unmasking in places like, say, Texas and Mississippi?

Mr. Krugman of the NY Times offers up a plausible explanation:

...Wearing a mask in public, like holding it in for a few minutes, is slightly inconvenient, but hardly a major burden. And the case for imposing that mild burden in a pandemic is overwhelming. The coronavirus variants that cause Covid-19 are spread largely by airborne droplets, and wearing masks drastically reducesthe variants’ spread.

So not wearing a mask is an act of reckless endangerment, not so much of yourself — although masks appear to provide some protection to the wearer — as of other people. Covering our faces while the pandemic lasts would appear to be simple good citizenship, not to mention an act of basic human decency...

{snip}

...Of course, we know what’s actually going on here: politics. Refusing to wear a mask has become a badge of political identity, a barefaced declaration that you reject liberal values like civic responsibility and belief in science...

{snip}

...Unfortunately, identity politics can do a lot of harm when it gets in the way of dealing with real problems. I don’t know how many people will die unnecessarily because the governor of Texas has decided that ignoring the science and ending the mask requirement is a good way to own the libs. But the number won’t be zero.

Of course, it would be silly for us to think that some of this same identity politics-based, anti-science thinking isn't brewing up here in Canada as well.

Personally, as members of the small flock of identity politics-driven trolls that have descended on this tiny, little F-troop list blog recently may already be aware of, I have no interest in debating them or their ilk. Instead, to swipe a phrase from the late, great Steve Gilliard, I only want to stop them.

OK?

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Here They Come...

SupplyAnd
DemandVille

Link

Heck yes, indeed.


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The Feds vaccine supply page is....Here.


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Where Did That Sixty Percent Maximum For High Interest Rate Loans Come From Anyway?

Multiplication

MattersVille


I don't know about you but I really feel for folks that are forced to go to high interest lenders to make ends meet.

Especially because the stories that result when things do not go well are heartbreaking, as was noted recently by the CBC's Dianne Buckner:

Patricia Edwards of Toronto wanted to help her two adult daughters when they fell behind on bill payments at the rented townhouse they share.

She has few assets and a poor credit history, but she was employed at the time, so she went to a payday lender — not for a payday loan, but for an ongoing line of credit.

"I was like, OK, let's see if I qualify for the loan because I'm working."

Edwards, 53, was able to borrow $1,500 early in 2019 from Cash Money. But then she lost her job, and in 2020 came the pandemic. She's had to refinance the loan twice, and went to another lender, Money Mart, for an instalment loan that could be repaid over two years.

Now she's close to $5,000 in debt, all in, paying nearly 47 per cent interest on both loans...


And, believe it or not, that 47% interest rate on the fifteeen hundred dollar principle is just fine and dandy because the objectionable number, as per Canadian law, is actually 60%, which is something that Senator Pierrette Ringuette has been trying to do something about for sometime now:

...Independent Sen. Pierrette Ringuette of New Brunswick has sponsored two bills to have the Criminal Code amended to lower the maximum interest rate that lenders can legally charge from 60 to 20 per cent plus the overnight bank rate. Neither bill moved forward due to prorogations and election calls, but Ringuette said she intends to sponsor another one...

****

So. 

Where did that  60% maximum interest rate number come from in the first place?

Well, it was a number arrived at, as HuffPo's Samantha Beattie recently noted, way back in the 1980's:

...Under federal law, lenders are allowed to charge anywhere below 60 per cent in interest on loans over $1,500 — a rule from the 1980s when the Bank of Canada’s interest rate was at 21 per cent...


And what is the current Bank of Canada prime rate?

Why it's 2.5%.

Which would make an equivalent recalibrated high interest loan rate maximum, if we used the three fold multiplier established back in the days when both Mr. T. and Brian Mulroney stomped on the terra, something on the order of 7.5%.

Thus, while I applaud Senator Ringuette's efforts to force a recalibration, it would seem that even her  20% maximum number might be a little high.

OK?

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Will America Be The Shining Vaccine City On The Hill?

.

The video, above, shows a certain septuagenerian country singer touting her COVID vaccine proudly and very publicly unlike, say, a similarly aged former president:

Former U.S. president Donald Trump and his wife, Melania, were vaccinated for COVID-19 in private during their last days in the White House in January, even as other leaders tried to set an example by getting their vaccines in public...

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Why does stuff like this, and further efforts from folks like Ms. Parton (who also Weird-Alified her hit 'Jolene' to 'Vaccine') to encourage everyone to get jabbed, matter?

Well, Americans are now putting vaccines into 2 million arms a day. Thus, the Biden administration seems to have dealt with the vaccine supply problem, so much so that the current (still barely) septuagenerian president recently predicted that they will have enough stock to jab everyone in the USA by the end of May.

But...

Unfortunately, it appears that a significant proportion of certain segments of the USian population are signaling that they just may refuse to get the vaccine:

If those refusals really do occur in significant numbers the situation in America could shift from a supply problem to a demand problem.

And with variants circulating, and mask mandates being prematurely rescinded, that just might lead to big, big trouble, indeed.



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Our favourite Jolene cover?....This!

As for our Canadian vaccine supply problem that we wrote about yesterday....The single jab J&J vaccine has now been approved...



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For Whom The Bells Toll...

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Lawrence Ferlinghetti reads the poem  'Allan Ginsberg (is) Dying', above.

The bells really do begin to toll at the 29 second mark. Watch how L.F. reacts.

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Mr. Ferlinghetti died last week at the age of 101.

We will still stop by his bookstore whenever we visit San Francisco. We will then cross Jack Kerouac Lane and have a belt at Vesuvio.

Even Herb Caen would not object to that I reckon.

OK?

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British Columbia's Sixteen Week Decision.

AsMuchCoverageAs

PossibleVille

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Update, Fri March 5th: The single shot J&J vaccine has been approved in Canada

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When we first heard about British Columbia's decision on Monday to maximize the first jab coverage of the COVID vaccines by extending the time to boost to four months on Monday we also heard that, despite Bonnie Henry's foreshadowing, the National Advisory Committee on Immunization (NACI) did not yet support the change:

...Henry said the B.C. CDC has been exchanging data with colleagues across the country and similar results are coming from Quebec, as well as from the U.K., Israel and other countries.

She also said the National Advisory Committee on Immunization (NACI) has been looking at the issue and will be issuing a statement on the matter in the near future.

As of (Monday) March 1, however, the advice NACI is providing on its website says that the interval between the first and second shots of the Moderna vaccine should be four weeks, the interval for Pfizer should be three weeks and the interval for the Oxford-AstraZeneca vaccine should be 12 weeks...


Well, that all changed yesterday, Wednesday, March 3rd.

First, in the morning, Justine Hunter and Ivan Semeniuk of the Globe and Mail published a piece saying, on the basis of statements from un-named sources, that NACI was going to change its recommendations:

An expert panel that advises the federal government on vaccination has determined that second doses of COVID-19 vaccinescan be given up to four months after the first, two sources say.

The shift from the National Advisory Committee on Immunization (NACI), which previously supported extending the interval between doses to no more than six weeks, would open the door for more people to receive their first vaccination while supplies are still limited. It would also lend support to other provinces to follow the new vaccine schedule B.C. adopted on Monday...

Then, later in the day on Wednesday, NACI made it official on their website:

• NACI recommends that in the context of limited COVID-19 vaccine supply, jurisdictions should maximize the number of individuals benefiting from the first dose of vaccine by extending the interval for the second dose of vaccine to four months.
  
  
• Extending the dose interval to four months allows NACI to create opportunities for protection of the entire adult population within a short timeframe. This will not only achieve protection of the adult population, but will also contribute to health equity

So.

What is the actual evidence that this will work?

Well, while NACI notes that there is real world evidence of efficacy of the first shot working for periods that extend past what was originally done in the phase III trials, they also explicitly state that the data for 16 week evidence of efficacy is not yet there:

• While studies have not yet collected four months of data on vaccine effectiveness after the first dose, the first two months of real world effectiveness are showing sustained high levels of protection

Here in B.C. our public health folks at the CDC have generated some of that first shot efficacy data in local long term care facilities as we noted earlier.

In addition, there is more of that real world evidence being generated in other jurisdictions such as the U.K., as reported by the British Medical Journal on Tuesday.

Having said that, there really are no four month data yet which means that monitoring will really matter (see below).

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Now, some will note that Anthony Fauci down south is still recommending that his country people to stick to the original specifications of the vaccine manufacturers for the timing of the second dose. However, it is important to further note that the U.S. has a whole lot more vaccine than we do which is precisely the matter at hand as Bonnie Henry reinforced on Tuesday.

The key here in Canada can likely be found in another bullet point from the NACI update:

• NACI will continue to monitor the evidence on effectiveness of extended dose intervals and will adjust recommendations as needed.

Personally, I hope that we hear more detailed specifics about how that monitoring will be done, both nationally and provincially, to ensure the best outcomes possible.

I also hope we have a Canadian decision on the single shot J&J vaccine, which has been approved in the U.S., as soon as possible (see update at top of post) given that increases in supply will make it easier to 'adjust' those 'recommendations' noted by NACI above to the best effect for everyone.

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Tip 'O the Toque to longtime reader Booey for reminding me of A. Fauci's position.

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More Evidence That A Safe Supply Would Save Lives

That other health care crisis that is killing people in British Columbia is not going away.

Andrea Woo of the the Globe and Mail, who has done much great work on this subject explains two of the reasons why:

The point being, fentanyl on its own is really, really bad.

But when it is mixed with benzodiazepines it is even worse.


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If you want more information and context on safe supply, from the folks who need it most, the 'Crackdown' Podcast and Website are good places to go...You may not agree with them entirely, but you will most certainly come to realize the human scope of the epidemic. 



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BC COVID Vaccine Rollout Schedule, Updated March 1st

TimeKeepsOnTicking
IntoThe FutureVille

Here's the latest, without the blather, as released by the province today...


Phase 2: (80 years and up, call your health authority beginning on the dates below; appointments for jabbing start the following week):

• March 8, 2021: Seniors born in or before 1931 (90 years+) and Indigenous people born in or before 1956 (65 years+) may call to book their vaccine appointment;
• March 15, 2021: Seniors born in or before 1936 (85 years+) may call to book their vaccine appointment; and
• March 22, 2021: Seniors born in or before 1941 (80 years+) may call to book their vaccine appointment.

Health Authority Phone #'s to call...

Fraser Health: 1-855-755-2455 (and online apparently....here)
Interior Health: 1-877-740-7747
Island Health: 1-833-348-4787
Northern Health: 1-844-255-7555
Vancouver Coastal Health: 1-877-587-5767

Phase 3: (60-79 years + those vulnerable 16 yrs and up)

- Staggered appointments beginning in mid-April

- Book appointment by phone and online (details to follow?) starting on March 31st.

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More on other specifics later....

And don't forget, with the J&J vaccine now approved by the U.S. FDA its approval is also very likely coming in Canada in the next couple of weeks which could further increase the provincial supply later in the spring.

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