Staff burnout and a limited supply of vaccines led to the decision to close some COVID-19 immunization clinics on the holiday weekend, the president of Toronto’s largest hospital network said Monday amid criticism of Ontario’s vaccine rollout.
“We’ve just burned our staff out entirely,” said Dr. Kevin Smith, president and CEO of the University Health Network, which is operating a COVID-19 vaccination clinic at its Michener Institute site.
“There is a limit beyond which we can’t push our hospital-based providers, and we’re at that point. People can’t take on any more. They really are burnt out and needed a couple of days’ downtime.”
With Ontario trailing every other province in its vaccination rate, the news that vaccinations were paused over the holidays was met with outrage, including from many health-care workers who took to social media to say they would have been happy to volunteer to administer doses.
“It’s hard for me to understand why we would take a break from vaccinations,” said Dr. Naheed Dosani, a palliative care physician. “This is undoubtedly going to contribute to suffering.”
The COVID-19 vaccine is currently being administered at 19 hospital sites across the province. All of the clinics were closed on Dec. 25 and 26. Five were open on Dec. 27, 10 were open on Dec. 28 and all will be up and running again on Dec. 29.
The province had administered more than 13,200 vaccines as of Monday afternoon, according to the Ministry of Health. At 90.7 doses per 100,000 people, it’s the lowest per capita rate of any province, according to the latest data posted by the website COVID-19 Tracker Canada. Quebec, by comparison, has administered 231.5 doses per 100,000 people.
Retired general Rick Hillier, chair of the province’s Vaccine Distribution Task Force, told CTV News that pausing inoculations was the wrong decision. “I take responsibility for that.
“We’ve been slammed. We’ve been spanked,” said Hillier. “We thought we honestly could start off with even more energy to go forward.”
NDP Leader Andrea Horwath called on Doug Ford’s provincial government to accelerate the number of vaccinations and publicly release a vaccination schedule.
“It’s disheartening and frustrating to know that tens of thousands of life-saving vaccine doses have been sitting in freezers,” Horwath said in a statement. “How many more people will get sick or die from COVID-19 as a result of these delays?”
Smith said those levelling criticism are “oversimplifying” the situation.
The staffing issues are primarily on the pharmacist side, he said, adding that each dose of the vaccine needs to be properly mixed and prepared. So unless the health-care workers volunteering their services have experience mixing vaccines, their offers of help aren’t much use. “It isn’t just about having someone put a needle in an arm.”
The other issue, Smith said, was the limited supply of vaccine at his site. The UHN clinic was given 7,000 doses and has distributed 3,000 of them, with an additional 3,000 reserved as the second dose for the initial recipients, as per the Ministry of Health’s guidance at the time.
Both the Pfizer and Moderna vaccines require two doses for maximum efficacy.
Smith said they could have kept the clinics running until they simply ran out of supply, but that would have meant fewer long-term-care workers would get vaccinated. In this initial phase of the vaccine rollout, Smith said, they are prioritizing long-term care workers before offering spots to hospital staff who work with COVID patients.
If they had administered the remaining doses only to hospital staff, they “would not have been fulfilling our mandate of getting this into the arms of people who we know are the most likely reason (COVID-19) is getting into long-term care (homes),” Smith said.
The policy of reserving second doses is no longer in effect, a spokesperson for Health Minister Christine Elliott said Monday. When the province first started its vaccination pilot projects at the UHN site and in Ottawa, clinical guidance recommended reserving a second dose “in the event of supply chain disruptions,” she said. Since Ontario received an additional 90,000 doses of the Pfizer vaccine from the federal government on Dec. 21, the policy was discontinued.
“We are not holding or reserving doses, and are vaccinating as many people as possible, counting on confirmed shipments of the vaccine that will arrive over the coming weeks for second doses,” the spokesperson said.
Elliott’s spokesperson said it was the hospitals that asked for the clinics to be closed over the holidays due to “staffing challenges.”
“We anticipate getting through the 90,000 doses at our 19 active hospital sites in the next several days as we await future shipments from the federal government.”
Dr. Isaac Bogoch, an infectious disease specialist at Toronto General Hospital and a member of the province’s COVID-19 Vaccine Distribution Task Force, said it’s not ideal to have any pause in vaccinations. But, he added, what’s more important is how the province handles the 90,000 vaccines it has now.
“How are you going to use them over the week ahead? That’s the thing I’m going to follow.”