Sask. needs to prioritize frontline essential workers for COVID-19 vaccination

This Opinion piece was written by Dr. Alexander Wong, an infectious diseases physician in Regina.

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I came home late one evening this week and reflected on my last week and a half on-call. 

Each day, as I walk through the various intensive care units here in Regina, I see more and more persons with COVID-19 infection critically ill and fighting for their lives. 

What is different now compared to the first and second waves of the pandemic is that I see men and women much like me. Many are around my age and otherwise healthy, they have young families like I do, they work hard to make an honest living and they provide the necessary services for our society so everything runs smoothly.

What differentiates myself from the many persons who are sick and dying of COVID-19, not only here in Regina but across Canada, is privilege. 

My family has had the ability to isolate in place during the pandemic in a spacious home. I was provided my full vaccination series for COVID-19 in mid-January as part of an initial pilot rollout for health-care workers. I order trivial items online for a few dollars and have them shipped to my front door the next day for free. 

The privilege that I and many others in society enjoy has shielded us largely from the worst of the pandemic. Life has become inconvenient, irritating at times. Work is busy and stressful. But it has not been a matter of life and death as it is now for many front-line providers and their loved ones.

Across all of Canada, the tragic reality we are now seeing is essential workers and their families are being infected with COVID-19 variants of concern and dying. 

While the vaccine rollout in Canada has been criticized by many, one clear success for the country has been how the rates of COVID-19 infection in long-term care homes have plummeted as a direct result of our system prioritizing these facilities and their residents early on.

This is proof of how prioritizing the most vulnerable at-risk persons not only saves lives, but also protects our hospitals from being overwhelmed — a win-win scenario for all.

Saskatchewan thus far has stayed firm with the intent of prioritizing access to COVID-19 vaccine by age, suggesting this is the most efficient way to roll out vaccines quickly. While this was true early on in the rollout and largely applicable to those aged 70 and older, the current reality shows us where the highest-risk populations now lie. 

Front-line essential providers — such as persons working in the food industry, child-care workers, front-facing personal service employees, warehouse employees and similar demographics — are bearing a disproportionate burden of infection and severe illness. 

Throughout the pandemic, these people and their families have struggled with inadequate sick leave and isolation support, and with limited to non-existent measures to maintain their safety in the workplace. 

Now, as if all of what they had suffered was not enough, they are becoming seriously ill and dying as variants of concern spread rapidly across Saskatchewan. Infection is acquired in the workplace and then spread widely at home.

Other critical work force members including first responders — police, firefighters, paramedics — workers in our health care facilities and long-term care homes, as well as K-12 educational staff, cannot be forgotten. They do not have the option to work from home or to isolate in place.

The most important role of vaccination in our province during this critical period of rapidly increasing spread of variants of concern is to reduce the number of persons who become severely ill and require hospitalization as quickly as possible. We can accomplish this by pivoting our approach to focus on persons at greatest risk in this third wave. 

With vaccine supply anticipated to increase dramatically in April, our system has the ability to maintain an age-prioritized approach while simultaneously increasing prioritization for at-risk groups mentioned above. 

The impact of our vaccine rollout on Saskatchewan’s third wave will be determined as much by who gets vaccinated and how quickly, as opposed to the number of vaccine doses administered each day.

Each day, Wong walks through the various intensive care units in Regina and sees more and more people with COVID-19 critically ill and fighting for their lives. (Submitted by Alexander Wong/Saskatchewan Health Authority)

New systems and access points will need to be rapidly put into place, such as in-workplace mobile vaccine teams, as was done for our long-term care facilities. We cannot forget about vaccine hesitancy, and supports must be established quickly to address individual concerns and optimize vaccine uptake in those at risk.

Outside of Yukon and Northwest Territories, Saskatchewan is leading Canada in per capita vaccine doses administered. Clearly, this province has the logistical expertise, leadership and infrastructure to do this work well. What is needed now is a shift in vaccine prioritization to front-line essential workers.

Doing so will not only protect the many thousands who selflessly sacrifice each day for the good of our society, but also reduce the impact on our hospitals, while saving as many lives as possible. That is a win-win scenario in my books.

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