26 November 2020

I have a Garmin watch that I use when I exercise, but lately I have not been activating the timing or distance settings, opting instead to let the way I feel set my pace and duration. This has been quite liberating, but I still wear the watch to know what time it is. The watch buzzes randomly, and when I look down, the word GOAL appears on the face, surrounded by party favors. I assume some sort of achievement has been reached, but I’m not sure what—no throwing, kicking, or shooting is occurring around me. Maybe the watch thinks I should be doing some planning instead of wandering aimlessly along forested paths, and it’s sending me motivational messages.

This got me thinking about goals for 2021. Seeing the end of the COVID-19 pandemic is probably the medical accomplishment most of us would like to attain in 2021. How our lives have changed in the last year!

I’m writing this editorial on American Thanksgiving, at which time daily case numbers and deaths have exploded worldwide. I watch the news with alarm, seeing how many of our southern neighbors have chosen to travel for this holiday. I shudder to think what the ramifications will be in a month’s time. I think many are in for a sad Christmas. Case numbers, hospitalizations, ICU admissions, and deaths in Canada, and BC specifically, have also climbed to the highest levels since the start of the pandemic. We have been advised to cancel all social gatherings and to keep to our immediate household bubble. Many of my patients confess that they have been cheating a little, often citing mental health as the reason. COVID fatigue appears to be a growing and worrisome reality.

One hope on the horizon is the promise of an effective vaccine. Three candidates have recently been fast-tracked for approval, all claiming over 90% effectiveness. The first to market is limited by the need for it to be stored at an extremely low temperature. The other two do not have this limitation but are slightly behind on the timeline.

What is not clear is how vaccines will be rolled out in Canada. Are we behind the United States in priority? Apparently, our federal government has signed contracts with seven vaccine developers but the details on timing and allotment of doses remain elusive. Since none of the vaccines are being developed in Canada, we are unlikely to be first in line. I am hopeful that this process will proceed in an orderly and calm fashion, but sadly some infighting among countries and provinces is likely.

Another issue is consumer acceptance and uptake of any available vaccines. The development process has been so politicized by the current American administration that public distrust appears to be high. Many of my patients have expressed safety concerns about fast-tracking of these SARS-CoV-2 vaccines. They are reluctant to be vaccinated; they worry about potential adverse health outcomes and ask whether I will get a shot. I explain that vaccines work by injecting dead viral protein, which stimulates the development of antibodies against the virus.

I reassure my patients of the safety of vaccines in general and add that I am a perfect immunization candidate due to my immune system being constantly bombarded by various foreign substances. My numerous scrapes and abrasions, secondary to my tendency to fall and crash my bike, are testimony to this fact.

Therefore, I will happily be vaccinated at the first opportunity available with a vaccine developed in North America or Europe. Forgive me, but I might be a little reluctant to be first in line to receive a vaccine whose name includes Sputnik. 
—David R. Richardson, MD