Vaccine roll-out critical to public confidence

ROSS FETTERLY  –  Jan 10, 2021

Canadian Forces Pandemic Support to the Province of Ontario

When any government is elected and assumes power for the first time, they initially come in with a plan and defined mandate to execute over their 3-4 year term in office. However, circumstances over that period often modify those priorities to some degree – and that is especially true when unexpected events emerge.

A pandemic emphasizes or reinforces the importance of Provincial government roles in the daily lives of the Canadian population. The COVID-19 crisis has upended people’s lives across the globe as is certainly the case in Ontario where the pandemic and will certainly be the defining characteristic of the Ontario conservative government’s current mandate under the leadership of Doug Ford. The extent to which the government is successful in immunizing provincial residents as quickly as vaccine shipments arrive, will shape their chance of winning a second term in office. 

The fundamental responsibilities of Provincial governments are the safety and security of its citizens. This includes setting the conditions for effective functioning of the provincial economy. Right now, the focus is on the effectiveness and promptness of vaccination immunization of the citizens of the province, which is subject of this commentary. 

With vaccines starting to be approved by the Federal government and distributed on arrival to the provinces, the overriding priority of the Provincial government in Ontario needs to be the immunization of its citizens as quickly and efficiently as possible.

On 25 January 2020, the first COVID-19 case in Ontario was confirmed in Toronto (it was a man who had traveled from Wuhan, China). Global concern was as inconsistent as the conflicting messaging coming from numerous credible sources. The World Health Organization declared COVID-19 a “global health emergency” on January 30 but didn’t declare a pandemic until March 11. On March 12, the Prime Minister’s office confirmed that his wife, Sophie Gregoire-Trudeau, had tested positive after returning from a speaking engagement in the UK – the federal government was suddenly taking this virus extremely seriously. That same day, and with the virus continuing to spread unchecked in Ontario, Premier Ford announced that publicly funded schools would be closed for the two weeks following March break. Then, on March 17, the Premier announced a state of emergency in Ontario. The next day, a nursing home in Bobcaygeon announced a coronavirus outbreak. These cascading events galvanized public attention on the pandemic, and the Provincial government took a more prominent role in frequent press conferences by the Premier and key Ministers. 

Now, in January 2021, Ontario continues to break daily COVID-19 case records. The Provincial government has been surprisingly slow in executing the immunization rollout of coronavirus vaccines. Specifically, they do not appear to have effectively planned for, or communicated, the rollout of this vaccination campaign over the previous months, even though they knew a rollout plan would be needed once the Federal government started to receive vaccine shipments. The Provincial government admitted that immunization clinics were shut down during the Christmas holidays due to staffing shortages, and raises questions as to the capacity of the Task Force to ramp up immunization when the Federal government starts receiving vaccines in greater numbers. Effectively staffing vaccine clinics in the coming months will be one of the key measures of performance of retired Canadian Armed Forces General Rick Hillier, who was selected by Premier Ford on 23 Nov 2020 to lead the task force to oversee the Ontario rollout of the COVID-19 vaccine.

To support more efficient provincial planning, the Federal government needs to better estimate quantities and dates of vaccine shipments. While the Provincial government has been focused on managing the spread of the virus, and brought in a former Chief of the Defence Staff on short notice to manage vaccine distribution, this late engagement of a retired military officer effectually admitted that they required outside expertise. This, in itself, is not surprising, as provincial governments are not typically involved in the logistics of administering vaccinations. However, parachuting an outside leader into an organization changes the internal dynamics, and it generally takes new leaders about three months to become effective. General Hillier rose to public prominence due to his leadership in the 1998 ice storm that paralyzed significant areas of Ontario and Quebec. His strong leadership skills and ability to succeed in challenging circumstances ensured that the 2020 appointment to lead Ontario’s vaccination effort was well-received by Ontarians. While much of the plan had been developed by provincial health-care professionals and administrators prior to his appointment, he is responsible for the distribution, storage, and administration of the vaccines.

The Ontario Vaccine Distribution Plan was released on 7 December 2020 and now needs to be updated for 2021. While emphasizing the background and outline of the program, benchmarks are needed for expected shipments from the Federal government and immunization plans for across the province. Without that information, the government vaccination plan appears to be incomplete and provincial authorities need to better communicate the roll out process to citizens. As Chair of the Ontario Vaccine Distribution Task Force and public face of the distribution plan in the province, General Hillier needs to be more specific on benchmarks related towards government distribution and immunization plans. 

For years, the standard rollout process for the annual flu shots in the province of Ontario, has been managed by local public health organizations, such as in community clinics operated by the City of Ottawa Public Health, and pharmacies in cities across the province. The program operates under established and standardized operating procedures that are assessed and updated on a regular basis. Surprisingly, utilization of this existing annual public health process does not appear to be the focus of the Provincial government. Taking a different approach from past practice will result in a steep learning curve. Nevertheless, citizens expect that, as increased volumes of vaccines are received by the Provincial government, the rate of immunizations will expand accordingly. However, the dearth of communication from experienced public health professionals related to the rollout at the local level of immunizations is not helping confidence levels.

The COVID-19 pandemic will likely be the most transformative event of our time.  It has highlighted the importance that provincial and federal governments have on Canadian society in a crisis, and will encourage governments to target spending on health care capacity and on planning for future pandemics.

This crisis has both magnified and amplified multiple broad-based challenges. Going forward, it can, and should, make governments analyze and shift their priorities and way of doing business. The Conservative government in Ontario is now facing a generational threat to its citizens from the COVID-19 pandemic, and has placed General Hillier in charge of the province-wide vaccination program. The legacy of both the government and General Hillier will depend on the success of the outcome.