TAGGED POSTS / special

COVID-19: The Road to Endemicity

by Raywat Deonandan, PhD
Epidemiologist & Associate Professor
University of Ottawa
(I add my credentials to these COVID-19 blog posts in case they get shared. I want readers to know that my opinion is supposedly an educated and informed one)

I’ve been blogging about this pandemic for almost two years now. One of my earliest posts on this topic was back in March of last year, in which I described the concept of herd immunity, as well as some other textbook ideas in epidemic management. Back then, these things were new to non-scientists, so that post went sort of viral (pun intended). Today, many people now have a degree of comfort with the terminology and basic concepts of epidemiology. But one idea is still relatively new to most: endemicity. (more…)

COVID-19: Even More Q&A

by Raywat Deonandan, PhD
Epidemiologist & Associate Professor
University of Ottawa
(I add my credentials to these COVID-19 blog posts in case they get shared. I want readers to know that my opinion is supposedly an educated and informed one)

Today’s post is a bit of a hodgepodge of topics people have been asking me to talk about. Let’s begin with a question from a concerned citizen, who asked:

(more…)

COVID-19: We Need A Vaccine Policy For Ontario Schools

by Raywat Deonandan, PhD
Epidemiologist & Associate Professor
University of Ottawa
(I add my credentials to these COVID-19 blog posts in case they get shared. I want readers to know that my opinion is supposedly an educated and informed one)

 

A major newspaper asked me to write an op-ed on mandatory vaccination for schoolchildren. But that was a week ago and it looks like they’re not going to run with it after all. So I guess I’ll just publish it here on my blog instead….


 

 

We Need A Vaccine Policy For Ontario Schools

There are four tools for making schools as COVID-safe as possible: ventilation, masking, screening, and vaccination. Ontario’s back-to-school plan relies on three of those. The glaring omission is any effort to maximize vaccine uptake among staff and students.

Mandating vaccination among some professions has widespread public support. Health care workers, first responders, personal care workers, and teachers are daily exposed to scores of people, many of whom are unvaccinated or vulnerable. The benefits of compelling vaccination for such professions far outweigh the risks, both physical and philosophical. Frankly, if you don’t want the jab, then get another job.

Adults in key jobs are one thing. But vaccinating children against COVID is quite another. For adults, the risk vs reward computation is straightforward. While vaccination poses a vanishingly small risk, the likely negative outcomes of actual COVID infection are so dire that vaccination is clearly the best choice. 

Children, on the other hand, do contract the disease, but less commonly. And some will develop “long COVID”, be hospitalized and even die, though seemingly at lower rates than adults. So for kids, the risk vs reward calculation is not as clear, since a tiny proportion of vaccinated children will experience serious, though treatable, adverse events, like mycocarditis. 

For kids, the personal risk and personal reward are both small. The tie-breaker might be the reward to society: getting a significant step closer to herd immunity. It might be mathematically impossible to get to that magical threshold without immunizing children.

This distinguishes COVID vaccination from the nine jabs that are presently mandatory for attending Ontario schools. They include tetanus and diphtheria and other diseases that were once societal scourges but that have been tamed by technology. In all nine, vaccination is intended primarily for personal protection. But for COVID, it would be mostly for the protection of others.

 While the COVID vaccine will likely be added to the list of compulsory shots eventually, now is not the time. This is because of the tightrope that public health communicators must presently tread to win the hearts and minds of the vaccine hesitant. Making this particular vaccine mandatory for children might drive the hesitant in to the arms of the hardcore anti-vaxxers who equate public health with authoritarianism. We would thus increase the behaviour we seek to suppress.

And make no mistake, we cannot afford to lose the battle for hearts and minds. We will need the cooperation of the entire populace in months to come, as booster shots become likely and as the struggle against COVID enters an endemic phase.

But not compelling student vaccination doesn’t mean having no vaccination policy at all. The price for exercising one’s bodily freedoms can include more stringent masking requirements, mandatory regular asymptomatic testing, and restriction from certain high risk extracurricular activities. 

We can cajole, incentivize, and educate our way to higher student vaccine uptake. Vaccine hesitancy is fueled by fear, misinformation and apathy. Making vaccination compulsory addresses the apathy, but accentuates the fear and creates vulnerability to misinformation. 

 

Meditations on Grief

I have lain claim to my father’s mug.

It’s been exactly three weeks to the hour since my father died. I’m taking a moment to write down my thoughts because I think I will want to know what I felt, some years from now when I masochistically relive this sadness.

I don’t want to dwell too long on this. Rather, here are some quick observations about where I am right now in this process.

I feel unbelievably fortunate to have had my father so long in my life. Many of my friends lost their parents earlier. I got to establish myself as an independent middle aged adult before losing my father, so the trauma is one of loss, not one of fear.

I feel grateful that my father passed relatively quickly after it became clear that a debilitating disease was threatening to strip him from us one layer of dignity at a time. It was a kindness that he left when he did, though in the end it was sudden and largely unexpected.

I am a little surprised by the depth of my own spiritual beliefs. I looked upon my father’s corpse and knew deep down that that was not him. He had gone elsewhere. This is not a scientific observation, but a deeply felt understanding of my universe. I am fairly convinced now that we are not bodies. We have bodies. And we leave them behind when we go on.

I cried openly and joyously. I’m shocked now that I no longer cry. The immediate grief was intense but very brief. Now I just have a general sense of sadness. And I do feel a tad guilty for only feeling light sadness and not crippling grief. Is not a proper son who so deeply adored his father supposed to be driven to his knees in dysfunctional grief? Yet I smile and tell jokes and continue on. Though my doctor spouse does describe me as “depressed” but “normal.”

I feel additional guilt because I went home to my spouse and child and my daily life did not change much. Whereas I know my widowed mother and childless siblings closer to home are feeling the change in their lives more acutely than I.

I feel comforted by the presence of my toddler, of whom one quarter comprises my dead father’s genetics. I tell myself that though my son calls me Daddy, he represents a piece of my departed Daddy to me.

I had steeled myself for feeling cheated that my son will not remember his grandfather. But instead I’m so very thankful that they had any time together at all.

Possibly the most sobering part of the process is something that I suspect every grieving individual has gone through. It’s that moment when you come home from the hospital, having just seen your loved one’s dead body, yet you find his half-drunk cup of tea, or his half-completed crossword puzzle, or the soiled pair of socks he had tossed side just hours before his final illness took his life.

It’s a reminder that death doesn’t work like how a TV show presents it. There are messy details. There is the detritus of life that lingers after the life itself has passed. There’s the wallet with loose change, the mail that still arrives, the clothes in the hamper, the spectacles folded atop yesterday’s newspaper, the bookmarked novel half-read, and the hat that he’d hung on the knob of his favourite chair that same day he was taken to the hospital.

The ghost that haunts the house is not an intangible spirit but a redolent assortment of loved and used objects still imbued with his flavour and touch.

Later this week, I will return to my parents’ house after having left post-funeral. And in my mind it’s still my parents’ house, not my mother’s. Because I know I will walk in and immediately greet my father’s chair as if he is still sitting in it.

A friend of my sister’s left a lovely poem on my father’s memorial sight. I am reproducing it here for posterity. It’s called “Death Is Nothing At All” by Henry Scott-Holland:

 

Death is nothing at all.

It does not count.

I have only slipped away into the next room.

Nothing has happened.

 

Everything remains exactly as it was.

I am I, and you are you,

and the old life that we lived so fondly together is untouched, unchanged.

Whatever we were to each other, that we are still.

 

Call me by the old familiar name.

Speak of me in the easy way which you always used.

Put no difference into your tone.

Wear no forced air of solemnity or sorrow.

 

Laugh as we always laughed at the little jokes that we enjoyed together.

Play, smile, think of me, pray for me.

Let my name be ever the household word that it always was.

Let it be spoken without an effort, without the ghost of a shadow upon it.

 

Life means all that it ever meant.

It is the same as it ever was.

There is absolute and unbroken continuity.

What is this death but a negligible accident?

 

Why should I be out of mind because I am out of sight?

I am but waiting for you, for an interval,

somewhere very near,

just round the corner.

 

All is well.

Nothing is hurt; nothing is lost.

One brief moment and all will be as it was before.

How we shall laugh at the trouble of parting when we meet again!


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