Ontario should refocus COVID-19 vaccinations on essential workers and hot spots, science table says

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TORONTO — Ontario should refocus their vaccinations on essential workers, their families and other residents living in COVID-19 hot spots, the province's COVID-19 science advisory table suggests.

In a report released Friday night, the science table said that prioritizing higher risk neighbourhoods and essential workers will “substantially reduce the overall incidence of SARS-CoV-2 infections,” as well as lower hospitalizations, ICU admissions and deaths.

“In Toronto, neighbourhoods with the highest proportion of essential workers in non-healthcare settings continue to experience a 3-fold higher incidence of SARS-CoV-2 infections as compared to neighbourhoods with fewer essential workers,” the report says.

“Accelerating the vaccination of essential workers, their families and other residents living in COVID-19 hotspots is projected to prevent considerably more infections in those aged 16 to 59 years.”

According to the science table, half of all COVID-19 cases in Ontario are within 20 per cent of neighbourhoods. At the same time, their analysis showed that residents of neighbourhoods with the lowest risk of COVID-19 are 1.5 times more likely to have received at least one dose of a vaccine.

The COVID-19 vaccination strategy thus far has been to prioritize people by age, chronic health condition, high-risk congregate settings, and then tackle hot spots and essential workers outside of the health-care sector.

Under the province’s vaccination plan as of April 7, about 25 per cent of Ontario’s vaccine supply has been directed to the province’s 114 at-risk neighbourhoods.

The science table is recommending a significant change to that distribution, with 50 per cent of the next three million COVID-19 doses be circulated to 74 of the province’s hardest hit hot spots.

Assuming vaccine coverage of 80 per cent in those aged 60 years and older and 70 per cent of those between the ages of 16 and 59, officials say that the vaccination of these hot spots could be completed within 25 days.

“The hotspot-accelerated vaccination strategy is also projected to prevent a larger number of infections in individuals aged 16 to 59 years and among individuals aged 60 years and above even though the strategy results in slower vaccination of individuals aged 60 years and above,” the report said.

“This is because the hotspot-accelerated vaccination strategy not only affords more direct protection to Ontario’s younger residents and essential workers in COVID-19 hotspots, but it also affords substantially more indirect protection to older adults in these hotspots even though they are vaccinated at a slower pace,” the report stated. The group said there are added benefits if warehouses, factories and other workplaces with large outbreaks would be prioritized.

The science table predicts that altering the vaccine strategy could prevent more than 56,000 infections, more than 1,700 hospitalizations, just over 250 admissions to intensive care units and more than 500 deaths between April 9 and June 7.

“Everybody will benefit,” Dr. Peter Juni, the scientific director of the science table, said in an interview with CTV News Satuday.

“Since people transmit less the virus because we actually start to see protection in these hot spot neighborhoods, everybody benefits, and also elderly people will get infected less. That's the take home message here.”

The report was released the same day that nearly 2,000 Ontario physicians penned an open letter asking the government to prioritize vaccinations for people at the highest risk of catching COVID-19, including targeting hot spots.

The physicians also asked for more support for workplaces where outbreaks are taking place—including “paid COVID recovery days”—and for clear and consistent messaging about the vaccines.