opinion: why canada is so far behind israel?

vaccination
israel procured fewer doses of vaccine per capita than canada, but because of better negotiations and a robust system to rapidly report outcomes of vaccinations, it received a large early allocation. canada negotiated getting most doses beyond april and thought this timetable was fine. as justin trudeau keeps reminding us — as we suffer from almost no vaccine doses in february — “we are still on track.”

vaccine rollout 
israel rolled out its vaccination program with the military precision you would expect from the vaunted israeli army. priority was defined early and effectively, vaccination notification occurred efficiently, and there were few glitches. in contrast, canada’s rollout has been slow, inefficient and with unclear prioritization. while we have a larger and more challenging geography, even toronto can’t get shots in arms efficiently. we have generals, but lack a battle plan and soldiers. there are so many questions that remain unanswered: how will people will be prioritized, and notified? will they have to log into overloaded and frustratingly inefficient websites as has been the case early on? what about those who aren’t internet savvy? when will pharmacies and private providers know their role so they can prepare?

vaccine efficacy
pfizer reported a 95 per cent vaccine efficacy based on a phase 3 study comparing infection rates in about 15,000 people treated, versus placebo control subjects. this data was critical for regulatory approval. it was equally essential to know how the vaccine behaves in the real world of mass vaccination. is it as effective as in the initial phase 3 trial?  does it prevent bad outcomes? canada has no idea, given our low vaccination rates. we can only disclose how many people remain at risk with no real timetable for getting it done.

the maccabi healthcare systems is israel’s second largest health maintenance organization (hmo) with 2.5 million members. when it reported the comparative differences in infection rates for 416,900 people who received the two pfizer vaccine doses, only 254 from the vaccinated group became infected, compared to the rates for 778,000 people not yet vaccinated — all within nine days after the second dose and none thereafter. by comparison, 12,944 infections occurred in the unvaccinated group. this demonstrates that the vaccine was effective in the large scale vaccination of a diverse population, with large prevention benefit equal to what was seen in the much smaller approval trials. even more exciting is that of the 254 vaccinated people infected early after the second dose, none died. this truly amazing data came from israel first, informs the world, and for the pfizer vaccine, demonstrates the protective effect of vaccination beyond simply disease prevention — it also prevents severe disease.

where to produce vaccine 
canada spent large amounts of money too late on facilities that can’t produce the most effective vaccines — indeed any useful vaccines — until late this year. we didn’t adequately support all potential vaccine developers in a timely way, by either substantial funding or cutting red tape. in fact, we often added red tape. israel is too small a country to produce vaccine domestically, it bought marketable vaccine early and focused on novel diagnostics and therapeutics

therapeutics
most countries will still need effective therapeutics to manage disease burden. the disease will not die out completely as people opt not be vaccinated and the disease will linger in poorer countries. so what’s the plan to treat residual covid-19? as we have seen throughout the pandemic, repurposed drugs that reduce viral load early in disease, such as remdesivir, have limited benefit. hydroxychloroquine works minimally if at all. even dexamethasone, however important to manage the immune over-reaction, data showed in the u.k. recovery trial that it only saves one life for every eight on ventilators and one out of 25 lives for those requiring oxygen. clearly, we need better options.

in canada, our scientists are excellent, yet underfunded and there is still so much we don’t know. a canadian funded study of peginterferon lamda-1 given as a single dose reduced viral load in early disease, but its benefit in reducing disease severity is unknown. the colchicine trial led by the montreal heart institute showed early benefit, but needs more data to prove it can reduce poor outcomes. and the anticoagulation trial co-led by toronto’s university health network, showed significant benefit in reducing complications due to clotting and will likely become standard therapy in hospitalized — but not critically ill — patients. it’s worth mentioning that the two latter trials were started by private donor seed money rather than an innovation incubator, and were later supported by peer reviewed funding, which is in too short supply and often underfunds studies as a result.

digital health care revolution
israel is famously known as the “start up nation,” having more start ups per capita than any country in the world. one company, diagnostic robotics , developed an ai powered platform to guide patient triage to the emergency room with a prediction model for acuity. during covid-19, its platform was used broadly in israel to help determine likelihood of infection and evaluate the need for going to the er, as well as provide anonymized cellphone tracking of contacts. the technology was good enough to partner with the mayo clinic, as well as the state of california. i personally attempted to connect both the provincial and federal governments with diagnostics robotics, which was offering canada its technology for free, however, both governments declined.

canada isn’t fine
justin trudeau has told us that all the recent angst about lack of timely vaccination is just “ noise ” and we will be fine. we will be fine when we have an integrated national disease database, adequately fund science, research and innovation and create a business environment that facilitates success. israel, the small country that can, has shown us the way to overcome what canada can’t.

share story

share this story

opinion: why canada is so far behind israel?

email

facebook

x

linkedin

copy story link