Viewpoint

Vivian Bercovici: Israel and Canada made different bets on vaccines. It shows

One-dose summer, two-dose fall doesn’t resonate here
People without face masks watch the sunset in Tel Aviv, Israel on April 18, 2021. Oded Balilty/AP Photo.

Vaccine supply. Yes. It really is that simple.

Since January 21, I have been fully Pfizered, having been administered two vaccine doses within 21 days of one another. I live in Tel Aviv and a stone’s throw from what happened to be the largest pop-up vaccine clinic in the country, processing 5,000 people each day. No lineups. No fuss.

As the world watched the wildly impressive vaccine drive in Israel, I had a front row seat. Within three months, approximately 90 percent of all Israelis over age 16 were vaccinated, meaning Passover, Ramadan and Easter were large, care-free family affairs this year.

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In January, I booked my usual August vacation in Canada, renting a cottage and looking forward to another iconic summer. I was certain that by summer things would be calmer, clearer, and more, um, predictable, in Canada. They are anything but.

Dose spacing. Mixing doses. Masks. Tests. Values and limits of quarantine measures. Jurisdictional bickering. Disagreements and lack of clarity among top public health officials. A tsunami of new numbers constantly, leading to utter confusion. I tried, but the chaotic messaging has overwhelmed me.

Here’s what I do know, though. I can travel quite freely in much of the world, in most places having to submit to a rapid test at the airport and then I’ll be free to go. To impose any quarantine, whether in a government hotel or not, on a fully vaccinated individual who tests negative for the virus is utterly irrational. It has nothing to do with science and everything to do with some sort of weird control issues.

Requiring me to quarantine for one day or two weeks upon arrival in Canada does nothing to protect Canadians or effectively manage COVID-19 contagion.

When I read recently that I would be subject to a $5,000 per person hotel quarantine fee upon arrival in Canada, regardless of my vaccine status, I was stunned.

Apparently, I am not alone in my befuddlement. A recent, random tweet of mine that I thought would just disappear into the ether, as they usually do, clearly hit a nerve:

Israel is a “green” country. In pandemic lingo, that means that everything is open and vaccinated tourists may visit. Life is, really, totally normal.

And there is one reason for that: Prime Minister Benjamin Netanyahu and Israeli health leadership understood that lockdowns were temporary measures to control contagion and that only a mass vaccine drive would effectively halt the spread.

And so, from the earliest days, the Israeli government planned aggressively for several scenarios, with a critical one being to ensure that the country had the ability to procure adequate vaccine supply from any one of a range of pharma companies in the race to be first. Spread the risk. Place your bets wisely but be ready to know when to pounce.

For all its tech and science prowess, Israel, like Canada, had no domestic vaccine production capability, rendering it entirely dependent on a clever and aggressive procurement strategy.

Perhaps the most important assumption built into the Israeli response was that a viable vaccine may well become available in the fall of 2020. In the spring and summer of that year, many countries thought that possibility to be impossibly optimistic.

In fact, it seems that Canada based its procurement strategy on the assumption that a viable vaccine rollout was not likely until later in 2021. Otherwise, they would have negotiated their supply very differently.

As it happened Pfizer was ready for showtime in November 2020, not 2021.

Throughout the summer of 2020 and, particularly, by mid-fall, Netanyahu and his key staff were obsessive about vaccine procurement, a fact confirmed by Pfizer CEO Albert Bourla.

Israel performed so well due to timely procurement of vaccine supply and expert logistical planning.

“He called me more than 30 times,” Bourla told Israeli TV anchor Yonit Levi. Bourla told of Netanyahu phoning him at 3 a.m. to discuss variants. He was obsessive, relentless and ultimately successful in negotiating the Pfizer global rollout in Israel. In return for aggregated data sourced from an ethnically and racially diverse population in a country with the ability to manage an effective rollout, Israel received a ready supply of vaccine.

Yes, Israel is geographically smaller than Canada. But that is not why the vaccine drive has been so successful here and quite the opposite there.

Nor is it that lockdown measures here were so brilliantly conceived and enforced. As in pretty much every Canadian jurisdiction, and many European countries, lockdown measures in Israel were downright loopy at times and managed very inconsistently.

There is one reason that Israel performed so well, particularly compared to Canada: timely procurement of vaccine supply and expert logistical planning.

That’s it. The rest is noise.

Recently, even Israelis, who tend to think that Canada is a land of unicorns and rainbows, have been asking me: what’s going on there? Word is out that Canada is a touch slow on the vaccine rollout.

“One dose summer, two dose fall” doesn’t resonate here. The statistic that tends to be reported and watched internationally is the percentage of the overall population that is fully vaccinated. Canada is still somewhere just over 15 percent of total population, which is what the EU and all countries consider when revising their travel advisories and directives.

One dose clearly reduces overall contagion rates but there are uncertainties in the Canadian approach that Europe will be watching carefully, in particular, whether new variants that enter the population before the second dose is widely administered will cause a new spike in cases and lead to a fourth wave. And there are concerns regarding the four-month dose spacing, which is significantly longer than the several European countries that have extended the time for a second dose due to supply issues as well.

Israel has another critical advantage over Canada: a state-funded health care system that has been fully digitized for more than 20 years. Call trees, spending days speed-dialing for appointments, long line-ups, fax machines(!), none of that exists here. For sure, there are issues to be addressed, but the impact of national digitization on efficiency in delivering care is extreme.

Among other metrics, the Israeli per capita spend on health care in 2018 was about half, perhaps less, than that for Canada.

And yes, I understand fully that health care operations, which would include digitization, is a provincial authority. So, consider this a gratuitous message to all provinces to address the obvious on an urgent basis.

But, in the end, even the most efficient provincial rollout could not mitigate a situation, as in Canada, where there simply was inadequate vaccine supply on a timely basis for the population.

While Trudeau was telling the world he would take care of the less privileged, having “secured” more doses per capita than any other nation, Netanyahu was busy ensuring that he had first dibs on the Pfizer vaccine, which had pulled ahead of the pack. He actually did “secure” the number of doses required for the Israeli population, which were delivered to Israel from mid-December and in arms within days.

It’s pretty clear that Canadian health officials planned for a more static scenario that saw vaccine supply becoming available in summer and fall of 2021. That was a very high-risk bet to place and we have since seen the results.

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