TORONTO -- A member of Ontario’s vaccine task force says that there will “absolutely” be some people jumping the line for COVID-19 vaccines in the second phase of the province’s rollout but he says the issue can be at least partly mitigated by having more family doctors administer shots.
The Doug Ford government has said that it will prioritize nearly three million people with pre-existing conditions as part of the next phase of its vaccine rollout but it has released few details on how it will identify those people and verify their medical history.
That has led to some concerns about queue-jumping, which could ultimately mean that the people most at risk of a severe outcome from COVID-19 have to wait longer for their shots.
“Listen it is not going to be perfect. Even if we have primary care expanded and in their clinics vaccinating individuals where they know their patients and they know who would be a good candidate for the first part of phase two and the second part of phase two that doesn’t fully solve this problem,” infectious disease specialist Dr. Issac Bogoch, who sits on Ontario’s vaccine task force, told CP24 on Tuesday morning. “There will be some honour system and you know what this isn’t perfect. There will be some people who jump the line, there will be, there absolutely will be. This is going to be a challenging thing to police.”
The Ford government has provided a list of 24 health conditions that would qualify residents for vaccines ahead of the general public and has broken them up into three categories – highest risk, high risk and at-risk.
Bogoch said that he doesn’t believe the issue of queue jumping will be a significant problem for the province, especially given the fact that the vaccines themselves will become a much less “limited resource” in the coming months.
But he said that the government will have to find some better ways to verify medical conditions and may have to “rely on peoples goodwill to wait their turn for vaccination” to a certain extent, as well.
“It is being billed as an 11 out of 10 problem when it probably is a two or three out of 10 problem,” he said.
Ministry says people with pre-existing conditions won’t be able to book appointments online
In a statement provided to CP24 on Tuesday, a spokesperson for Health Minister Christine Elliott said that planning is still underway on how the province will deal with people with pre-existing conditions.
The spokesperson, however, said that “these individuals will not typically be booking their appointment through the provincial online booking portal, or receive the vaccine at mass vaccination clinics.”
Instead, the spokesperson said that most of the vaccinations administered to people with pre-existing conditions will be “administered through other channels, such as specialty clinics or through their existing health care providers who already have the individual’s health records on hand.”
That would, in theory, negate the risk of so-called queue jumping.
But it remains to be seen how far the province will go when it comes to verifying information about medical conditions, especially for those people who may not have family doctors.
“Maybe we would prefer they have some proven evidence? I would rather have people say, if you have a condition, and it is personal private information, it's their health information,” Chief Medical Officer of Health Dr. David Williams conceded during an interview with CTV News Toronto on Tuesday. “We trust them to say that and to declare that. If they want to bring some evidence of that, what would they bring?”
Williams said that he understands that some people may be included to try to “bypass the system and get around the system” but he said that they should remember that the priority list has been set up the way it has to save lives.
Of course, some people are still concerned about whether the most vulnerable people will indeed receive their shots first in the second wave, especially when you look at the sheer number of Ontarians with pre-existing conditions.
Speaking with reporters at Queen’s Park on Tuesday, NDP Leader Andrea Horwath said that the government had “literally a year to put together something that people could have confidence in” but still seems to be “making things up on the fly.”
She said that the lack of a concrete verification system could mean that “the people who are perhaps going to have to stop people from getting vaccines inappropriately or at the wrong time is the frontline providers.”
Dr. Michael Warner, the medical director of critical care at Michael Garron Hospital, also raised some concerns in an interview with CP24 on Tuesday. He said that the issue is that the government has set up a system, where there is “is no specificity in terms of what a respiratory disease is, what heart disease means.”
That, he warned, could lead to widespread abuse, especially if family doctors are kept out of the process.
“It means that the people who need the vaccines the most will not be triaged to get them earlier than others and also family doctors have been cut out of the entire process,” he said. “They are the ones best equipped to triage their own patients assuming we have carve outs for those without family doctors to make sure they get access too.”
Ontario has said that it hopes to vaccinate an additional 7.5 million residents as part of the second phase of its vaccine rollout.
Other priority groups include older adults, essential workers and those who cannot work from home, along with residents and staff in congregate settings.
