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Dr. Nazeem Muhajarine, professor of community health and epidemiology, University of Saskatchewan College of Medicine, and member of the Coronavirus Variants Rapid Response Network (CoVaRR-Net)supplied

Q&A with Dr. Nazeem Muhajarine, professor of community health and epidemiology, University of Saskatchewan College of Medicine, and member of the Coronavirus Variants Rapid Response Network (CoVaRR-Net)

What have we learned from the coronavirus pandemic?

In early 2020, the world – including the public health research community – appeared to be unprepared for the coronavirus outbreak that quickly turned into a pandemic. The World Health Organization, for example, didn’t have a solid game plan, and we lost some early opportunities to minimize and contain the spread.

Without a common playbook, different countries and regions tried different approaches, especially during the early stages. Some implemented aggressive prevention and containment strategies, including border controls and testing, tracing and isolation requirements, while other countries were less stringent in their approach.

Insights from different outcomes can inform our strategy going forward. However, public health measures, such as social distancing, masking and vaccinations, were often applied in concert with each other, and this makes evaluation of what works and what doesn’t – and attributing certain outcomes to a specific response or set of responses – difficult. Yet there are ways of getting around this challenge, and that task currently preoccupies the research community.

How is CoVaRR-Net helping to guide Canada’s pandemic response?

Addressing a novel infectious disease requires prevention and mitigation measures that are based on the most current scientific evidence. Investigating and disseminating research on variants of the SARS-CoV-2 virus is the mandate of CoVaRR-Net, a national research network, where I am co-leading the pillar dedicated to public health systems and social policy.

We’ve been involved in helping to set policy direction with written briefings called SBAR (Situation Background Assessment Recommendation). The topics we have tackled range from vaccine breakthrough and rapid tests to having safe holiday seasons. As the name suggests, these documents go beyond evidence synthesis – to come up with science-based recommendations for federal and provincial governments, health authorities and the general public.

What role do immunizations play?

COVID-19 vaccines, which were developed very quickly, have come with an unprecedented level of complexity in procurement, distribution, administration and evaluation of real-world effectiveness. At the moment, over 80 per cent of Canadians have received two primary doses of the vaccine, and many have gotten – or are in line for – their first or second booster shot.

Despite this impressive track record, I’ve been surprised by the prominence of Canadians who refuse vaccinations. I am especially concerned about vaccine hesitancy among socially marginalized groups, where disparities in vaccine uptake have had detrimental consequences for already vulnerable communities, including higher numbers of infections, hospitalizations and deaths.

A critical, yet not surprising, lesson we have learned from the coronavirus pandemic is that we really need to pay more attention to our marginalized communities.

How can vaccine inequities be addressed?

Our work within CoVaRR-Net has compared the immunization rollout campaigns across Canadian provinces and has provided some valuable insights. Nova Scotia and B.C., for example, set explicit goals for population-level vaccine uptake and also used centralized booking and registries – and this proved helpful. These provinces also made reaching vulnerable populations a priority.

In addition, we saw good results from strategies that incentivized getting immunized by rewarding vaccinated people, for example, with access to restaurants and venues that required proof of vaccination.

Is there one course of action that can make a big difference?

Any science-based policies and practices will be more effective if we have good and comprehensive data systems. We need to collect data at a community level that can then be integrated into provincial and national data sets.

Immunization records are a prime example. Canada needs a national immunization registry, where we can link vaccination data to overall health outcomes. It’s time for the federal government – as trustee of the Canada Health Act, funder of health care and procurer of vaccination doses – to take the lead in building national data platforms. The federal government needs to enter into a partnership with provincial and territorial governments to build public health data systems. This is long overdue in Canada.

Any other insights you’d like to share?

In many places, we saw a tussle between politics and science, and where politics had the upper hand, outcomes were typically poorer. In some countries or jurisdictions, responses to COVID-19 were largely driven by political ideology, a so-called “freedom narrative.” Others focused on a “we are all in this together” kind of refrain that encouraged taking care of each other and keeping human loss at a minimum.

In Canada, particularly at the federal level, I believe we had a strong and empathetic response.

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