This year’s hockey playoffs have had a special poignance for Canadians, not restricted to long-suffering Edmonton Oilers and Toronto Maple Leafs supporters. While the U.S.-based teams’ arenas are filled with fans, the Canadian teams have had to play, dispiritingly, before rows and rows of empty seats.
The difference – a United States that has almost fully reopened after the lockdown, versus a Canada that is just beginning to – is not wholly explicable in terms of American rashness vs. Canadian prudence (or if you prefer, American libertarianism vs. Canadian nanny-stateism). There’s a substantive basis to it.
The average daily number of new cases in the U.S., three times as high as in Canada, per capita, at the start of the year, is now a third lower. It’s falling in both countries. But it has fallen further, and faster, in the U.S.
The reason for this is not hard to find. The U.S. vaccinated more of its citizens, sooner – much more, much sooner – than we did, and is reaping the benefits. It is the same reason Israel and Britain, two other early frontrunners, have also been able to open their societies faster.
That has tended to get lost in all the recent hoopla over Canada having caught up to and indeed having surpassed the U.S. vaccination rate. It did so, we should note, by one particular measure: the proportion of the population that has received at least one dose (now at roughly 58 per cent in Canada, versus just more than 50 per cent in the U.S.). While that is indeed cause for celebration, two further points are worth highlighting.
First, the public-health impact of the early, and wide, U.S. lead in vaccination was not extinguished with the closing of the gap. Two countries may end up vaccinating the same proportion of their citizens, but the one that vaccinates more of them earlier will suffer fewer infected and fewer dead. Put simply, a vaccine today is worth a great deal more than a vaccine tomorrow, let alone six months from now. Because it isn’t just the people vaccinated who are thereby spared infection – it is all the people they might have infected in their turn.
And second, a much larger proportion of the U.S. is fully vaccinated, having received the requisite two doses – 41 per cent, to Canada’s 5.5 per cent. In choosing how to allocate its (more limited) stock of doses, Canada preferred to half-vaccinate a larger number of people, rather than fully vaccinate a smaller number.
It was absolutely the right strategy, in the circumstances: The marginal public-health benefit from the first dose, which is typically 60 per cent to 80 per cent effective at preventing infection, was considerably greater than that from the second dose, which raises the vaccine’s effectiveness by only another 10 percentage points or so. But it was triage: With fewer doses to go round, Canada had to make harder choices.
Well, it wasn’t just about a lack of doses. Canada had to cast its net wider, because a much larger proportion of its population was, and is, still vulnerable to the disease. Measured by the number of confirmed cases, nearly three times as many Americans have been infected, in proportion to their population, as Canadians: 10 per cent, to Canada’s 3.7 per cent.
Given that the number of actual cases is conservatively estimated to be four times the number of reported cases, that means something like 40 per cent of the U.S. population would presumably be immune to the disease, independent of any vaccine campaign.
Suppose you need 80 per cent of the population for herd immunity: the point at which the virus begins to die out for lack of fresh victims. Combining the 40 per cent of Americans who have probably had the disease with the 40 per cent who have been fully vaccinated suggests the U.S. is pretty close to it already. Whereas in Canada the combined figure would be nearer to 20 per cent.
So fine, the one-dose strategy was a good start. But of late, getting second doses into people has taken on greater urgency. Because in the meantime a new and much more transmissible variant of the disease, B.1.617 (also known as the variant first identified in India), has emerged. Data suggest our existing stock of vaccines can protect us against this strain, but at a lower rate of effectiveness, especially for those who have only had one dose.
Since more Canadians than Americans are still vulnerable to the disease, more are likely to get the new variant and to spread it to others. Which means the threshold for herd immunity will likely prove higher in Canada than in the U.S. A further consequence, alas, of our slower start: not only a later finish, but a longer course.
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