Canadians continue to be tricked, not treated
Ongoing workplace vaccination requirements are callous as Ontario's and Canada's COVID-19 hospitalization data no longer show protection from the shots.
Preamble
For last year’s Halloween, I led the publication of one of my favourite COVID-19 commentaries: “Mandatory experimental shots – Canadians are being tricked, not treated“, also available at https://academics4covidethics.ca/mandating-experimental-shots_oct2021.pdf. We argued that “Coercing COVID-19 vaccination in schools, colleges, universities, and workplaces makes little sense and could cause significant harm.” In the conclusion, we outlined different “treatments” as alternatives to this “trick”.
For the one-year anniversary of Canada’s workplace COVID-19 policies, I just published “Remembering the 2021 Fall of Shame” as an op-ed for the Western Standard this week. Unfortunately and in contrast to numerous countries that have thrown the pandemic in the dustbin of history, Canada, and more so the Province of Ontario, don’t seem to be quite done with the madness. This blog post is motivated by the inquiry from a community member about one among many jurisdictions in Southern Ontario that maintain a workplace vaccination mandate. Apparently, they use Public Health Ontario’s report on “Severe Outcomes among Confirmed Cases of COVID-19 Following Vaccination in Ontario” to back up this policy.
I am very aware of the cruel impact of COVID-19 vaccination requirements for employment, not just from my own experience, but moreso from that of unvaccinated students who are systematically excluded from internships or entry-level jobs. In my field, the public sector is an important employer and many students gain their first work experience with e.g. the City of Toronto. Yet, “All City of Toronto employees are required to be fully vaccinated as a condition of hire in accordance with the City's Mandatory Vaccination Policy”. That policy is badly outdated to begin with, as it refers to the Delta variant (which is extinct in Ontario since about eight months according to genomic surveillance) and claims that “vaccination has been shown to be effective in reducing COVID-19 virus transmission and protecting vaccinated individuals from severe consequences of COVID-19”.
[Note that just before publication of this post, the City dropped its mandate as the city manager is quoted stating that “the science (sic!) and public health guidance no longer (sic!) supports the need for a mandatory vaccine policy.” Let’s hope that other employers will rapidly follow instead of hanging on to the Cult of Big Pharma.]
I have written since almost a year and a half that the COVID-19 injections were not developed or tested to prevent transmission, and that studies conducted after the widespread administration of the vaccines typically showed only marginal protection from infection and transmission. Outbreaks in events and settings that excluded unvaccinated people also prove this point, and the epidemic curves for most jurisdictions do not seem to be impacted by vaccination rates, and certainly not in the hoped-for direction. Therefore, vaccine mandates never made any sense from the vantage point of “ending the pandemic”.
But maybe some jurisdictions are concerned about hospital overload and think workplace mandates will contribute to “protecting the health care system” by forcing individuals to (presumably) protect themselves? Setting aside the issue that the health care system should protect us, and not the other way around, let’s have a closer look at the severe-outcomes report for Ontario (and its Canada-level equivalent) and determine whether vaccination does indeed save health care system resources. We’ll examine the data “tricks” used by the agencies and then apply a “treatment” in order to “heal” these data.
Issues of data classification and aggregation
The following image is taken from a December 2021 post on UK professors Norman Fenton’s and Martin Neil’s blog “Probability and Risk” that I recently rediscovered. The three personas Fred, Jane, and Peter illustrate misleading categorizations of COVID-19 cases, hospitalizations, and deaths. They are easier to understand and more compelling than the “Definition of Terms” and “Data Caveats” that are included in the PHO report (page 13 and 14-15). The report is clear in that cases within 14 days of first-dose vaccination are included in the unvaccinated category. In contrast, the PHAC report defines two additional categories, (1) not-yet-protected cases for the first 14 days after dose 1, followed by (2) partially-vaccinated cases until 14 days after dose 2, and they correctly exclude them from their charts rather than mixing them with the truly unvaccinated cases.
The “from/with” issue of hospitalization due to COVID vs. incidental finding of COVID during hospitalization due to another reason (e.g. Fred’s car accident above) is not mentioned by PHO or PHAC. As per Ontario’s “Breakdown of COVID-19 positive hospital admissions” dataset, as of 3 November 2022, less than 37% of COVID-positive hospitalizations and 63% intensive-care unit occupants were admitted because of COVID. To reiterate this important data limitation, less than 4 out of 10 “COVID hospitalizations” were caused by COVID-19, and less than two-thirds of “COVID ICU patients” are in Ontario’s ICUs because of COVID-19.
Additionally, let’s keep in mind that — despite the prevailing narrative — COVID-19 is just one of many serious diseases out there. As of November 3, the dataset for “Availability of adult and pediatric ICU beds“ shows that 1,825 of Ontario’s 2,341 adult ICU beds were occupied, with over 500 remaining available. Based on data from “COVID-19 cases in hospital and ICU, by Ontario Health (OH) region”, there are 117 COVID-positive ICU patients as of the same day. In other words, COVID-positive patients account for a mere 6% of current ICU use (or 5% of total ICU beds)! I could not find current occupancy and availability of all hospital beds, thus the focus on ICU here. But aren’t open data a beautiful thing?
The absolute kicker though is the use of cumulative case counts in the government’s epidemiologic reports. This time frame is all but hidden in the PHAC report, while it is explicitly included in the title of the PHO report and in their table captions. The effect of using cumulative data is that the raw counts of unvaccinated COVID-19 cases, hospitalizations, and deaths from the first half of 2021, when the vaccination campaign had just started, are being carried forward to this day, making the current severe outcomes among unvaccinated look much less favourable than they are. Current analyses and decision-making should not be based on these data! In addition, the vaccinated groups in the PHO and PHAC reports are split into recipients of 2, 3, and more doses, thereby further obfuscating the relationship between vaccinated and unvaccinated counts.
Before proceeding to remedy these issues, I must reiterate that severe outcomes from COVID-19 are highly concentrated in older adults. This characteristic age distribution was observed repeatedly since February or March 2020 and should have led to focused protection of vulnerable populations and development of early treatment protocols, instead of blanket mobility restrictions, global mask mandates, and indiscriminate vaccination. The workplace vaccination mandates may well be depicted as peak absurdity in a series of pandemic response measures of the last 2.5 years that would have failed any logical and ethical test if such a test had ever been applied to them.
Recent COVID-19 outcomes by vaccination status in Ontario
In order to examine current trends in severe COVID-19 outcomes by vaccination status for Ontario, we need case counts for recent time periods rather than cumulative counts. PHO does not seem to provide access to older copies of their report. Using the Internet Archive/Wayback Machine for the URL of the severe-outcomes report, I was able to access seven reports with data as of Jan 16, Feb 27, Apr 10, Jun 5, Aug 14, Sep 11, and Oct 10. I used these to create six tables with the differences of values in Table 3 shown above, between the adjacent time stamps. Importantly, the time elapsed between the available reports varies, thus the absolute numbers will vary as well and we can only examine proportions between the vaccinated and unvaccinated categories for each time period.
I combined the four vaccinated groups into one, keeping in mind that vaccinated people within 14 days of dose 1 were included in the “unvaccinated” group by PHO. Looking at hospitalizations only, there were about twice as many vaccinated COVID-positive patients as unvaccinated at the beginning of 2022. This proportion has grown to over five times as many vaccinated. With the most recent 84% of COVID-positive hospitalizations being vaccinated, we are approaching the 91% of Ontarians age 5 and older (the age threshold used in the PHO report), who have received at least one dose according to the COVID-19 Vaccination Tracker. Without considering age distribution and other factors, there appears to be a small and diminishing benefit from being vaccinated with respect to hospitalization.
I completed the same data “massaging” for the 60+ age group since these are individuals most susceptible to severe outcomes from COVID-19. However, the most recent proportion of vaccinated elderly patients is 87% or more than six-and-a-half times as many as unvaccinated. With a vaccination coverage between 93% and 95% in the three oldest age groups included in PHO’s vaccine uptake report, our findings are the same as for the total population of Ontario: the vaccines provide limited and waning protection from hospitalization. These results may also depend on the various “data caveats” listed in the severe-outcomes report, only few of which were discussed above.
Please note that while the report’s Fig. 1 (daily hospitalizations) confirms our finding that throughout 2022 hospitalizations among the vaccinated have increasingly exceeded the unvaccinated, Fig. 4 (hospitalization rates during previous 120 days) and Fig. 2 (7-day average hospitalization rate of elderly) both show far higher (more than double) rates for unvaccinated patients as compared to those vaccinated. The report’s “highlights” refer to these rates as they claim benefits from primary vaccination and additional benefits from boosters. I am unable to replicate these rates but I note that they may be sensitive to the various issues with these data.
Recent COVID-19 outcomes by vaccination status in Canada
When Substack blogger Sheldon Yakiwchuk provided a “COVID Current Snapshot” a couple of days ago using Canada-wide data, I became curious to check whether the Ontario trends would also hold nationally. I secured the Public Health Agency of Canada’s (PHAC) “COVID-19 epidemiology update” and was pleased to find a link to an archive of all previous, weekly reports. I accessed four copies of the report with data as of July 3, July 31, Aug 28, and Sept 25. Subtracting the more recent from the older data leaves us with three periods of four weeks during summer 2022, as shown in the following stacked barchart.
These disaggregated PHAC data show an almost identical trend as the PHO data: in July and August, 84% of COVID-positive hospitalizations were fully vaccinated, and most recently, this proportion grew to 85%. Compare this to Canada’s vaccination coverage of 86% as of 11 September 2022 (primary series completed among people 5 and older) for an even smaller, if any, benefit from vaccination than in the Ontario case. Note that the “primary series completed” category is the most fitting comparator as the PHAC report excludes the not-yet-protected and partially-vaccinated groups as noted above.
For Ontario, we had a look at one age group (60 and older) in addition to the overall pattern in the data. For Canada, instead, we’ll take a peek at the other severe outcome: death. Over the three time periods, the proportion of unvaccinated COVID-positive deaths fluctuated between 14% and 15%, which is in line with the September 11 proportion of 14% of people 5 and older, who had not completed a primary vaccine series.
Deaths with a primary vaccine series completed had a data error in the first time period, followed by 13% and 11%. Those with one booster dose displayed a declining proportion among deaths, from 60% to 45%. Lastly, and most concerningly, the double-boosted are the only group with a growing contribution, from 26% to most recently 30% of all COVID-positive deaths. According to the above vaccination-coverage site, only 14% of Canadians aged 5+ were double-boosted as of September 11. While there are likely confounders to be examined more closely, e.g. average group age, we must note that on the surface, the second booster seems to double the risk of death from or with COVID-19.
Conclusions
There is more to be done with the Ontario and Canada data on COVID hospitalizations and deaths by vaccination status — extend the tracking periods, examine all age groups — and similar analyses should be conducted for other jurisdictions, too. As just one example, a short Twitter thread by Olaf Garber asks “Why are the unvaccinated disappearing from ICUs?” He shows that vaccinated patients occupy more than 88% of Germany’s ICU beds, up from just 40% at the beginning of 2022. Garber also shows the age composition of ICU population with a concerning increase of the proportion of those 80 years and older from 10% to 30% over the course of the year at the expense of the 50-59 year-olds.
The mRNA vaccine trials supposedly showed effectiveness of 90% and higher. Product authorizations required 50% reduction of symptomatic COVID-19, if I recall correctly. Efficacy in the real world seems to have diminished to meagre single-digit or teen percentage values. Is this a solid legal or ethical basis for mandating the injections? The question is exacerbated by the fact that the “safe & effective” cliché has two dark sides, not just the ineffectiveness of the shots but also their risks. In January, fellow blogger Bill McMullin observed that vaccine mandates force us to take a risk in order to remain free. In normal times, there is no way that this level of unjustifiable coercion could have been implemented and maintained for this long.
Thank you to several colleagues within and outside of Canadian Academics for Covid Ethics for sharing information related to this post’s topic and for providing feedback on a draft.