You asked, he answered: our reader-driven Q&A with Richard Stanwick

Province of BC / Flickr

With higher-than-normal case numbers and ongoing outbreaks intersecting with critical decisions about vaccine rollout, Vancouver Island is at a pivotal moment in its pandemic response. Decisions made by policymakers today could determine how quickly life gets back to normal in the province.

Last week, more than 1,000 Capital Daily readers sent in their questions about how Vancouver Island is managing the second wave of the COVID-19 pandemic, the immunization drive, and other pandemic-related issues.

On Wednesday afternoon, we put those questions (and some of our own) to Island Health Chief Medical Health Officer, Dr. Richard Stanwick.

The transcript has been lightly edited for length and clarity. ‍

Has there been any evidence that the UK variant of COVID-19 is spreading on Vancouver Island?

I can confirm that there were three individuals who did have that particular variant. It did not go beyond them because the individuals practiced the measures that the federal government and [BC Chief Medical Health Officer] Dr. Henry asked them to follow once they were identified.

Nevertheless, as we’re seeing in the media and certainly from what Ontario is reporting, the variant does appear to be becoming established in that province. I think the other major worry, other than people coming from the United Kingdom, is the fact that the United States has not put any restrictions on travelers from that part of the world.

So given the enormous number of cases that are occurring there, it is likely that somebody could be going to the United States [from BC] and acquiring it there rather than travelling to London, UK, for example.

What we've seen on Vancouver Island over the past couple of weeks is that cases are on the rise, especially in the central part of the Island. Can you tell us whether this is because people gathered over the holidays, because there was travel, or because of something else?

The answer probably is a combination of all of those factors. We’re definitely seeing a second spike, one that is very similar to what we witnessed after Halloween.

What really reflects the fact that [public health restrictions] were not necessarily observed to the degree that I think Dr. Henry would have liked, is ...  the rates of transmission, the R-naught number, is above 2.7, when in the summertime we were at 0.1. A single individual now is theoretically passing [the virus] to more than 2.7 other people.

This is what's going to interfere with flattening the curve. The curve will increase in slope as a result, so we're worried. We have nearly 600 contacts we’re following up with, and this is very similar to what we witnessed back in November.

Speaking of the spike in cases, looking at the BCCDC dashboard, Island Health region’s current testing rates are way below what they were in November when case rates were last spiking, but test positivity rates now are almost double what they were in November. Why has testing gone down in the region this year, and what is being done to bring it back up?

One of the reasons why we see a slight reduction in testing is that the criteria that BCCDC have established for coming in and getting tested has been slightly modified. However, we don't believe that alone accounts for the significant drop. We were seeing a decline heading into the holiday season for which we really didn't have a good explanation.

It was pure speculation [but] people were thinking, well, maybe it's that people don't want to get tested because they don't want to be isolated over the holiday season and be by themselves.

The doubled rate of positivity is probably a reflection of concentration in the pool of people [who do get tested]—we're still getting enough people coming in who do have symptomatology, so we're picking them up.

We want people to know that if they're at all concerned about having those symptoms of COVID, to go to the BCCDC website, and we can get you tested within 24 hours. Our labs are fully functioning and will basically get that result back to you within 24 hours.

Switching gears a little bit to the immunization rollout: how will people be contacted when it's their turn to get a vaccine? Is there some sort of directory people need to be on?

The provincial government will be having, I think, a significant campaign to alert people as to how they're going to be doing it.

I can tell you a lot of thought and preparation is going into exactly who, when and where. But this is going to happen, again, as a provincial initiative.

We know that on Vancouver Island, immunization efforts stalled over the new year because supply ran out. So I'm wondering, how much Pfizer and Moderna vaccine has been delivered so far, and what can we expect to receive in the coming weeks?

If I had the answers to those questions I'd be the most popular person in our health authority!

One of the big challenges is that, you know, for example, a shipment we were thinking we were getting tomorrow is going to be probably not arriving till late Friday. Up to yesterday [Jan. 12], we basically immunized, I think, 7,315 people and we’re immunizing people today.

So that number will continue to climb. We are expecting more shipments. In fact, I think we're due for a Pfizer shipment that probably is here today. We’re certainly looking at when the Moderna vaccine comes in—that’s what we’re hoping to get towards the weekend—we’re looking at how we might be able to move that out into the community and start doing our long-term care facilities.

We've received some tips about how Victoria General Hospital had their supply of vaccines cut off or slowed down due to storms at one point recently. So are we more vulnerable to vaccine supply disruptions because we're on the Island?

We do worry about the fact that it could result in delays. Transportation is a big issue. One of the big challenges is not only getting the vaccine onto the Island, but because many like we have many First Nations communities on the Island...these individuals may only be accessible by boat or by plane.

For example: one of the earliest priority populations were some of our most rural and remote First Nations populations. There were eight communities who were identified as being high risk, one because some have actually experienced cases and had an outbreak and others were equally vulnerable to such an event.

We actually had people driving the vaccine out to these communities, over New Year's Eve and into New Year's Day to get it out there. Because that was the time where we had a window of opportunity in terms of weather. These people rely on roads that are not always passable.

How, exactly, do we get the vaccine here on Vancouver Island? Does it arrive by ferry or by airplane?

Basically it’s the responsibility of FedEx that does it. I believe it does come over by special vehicle.

We’ve had some challenges where everybody's ready and waiting and then you get the tracking number and it says it's still sitting in Richmond. It's like you're waiting for that wonderful present that doesn't arrive on time.

But there's been some amazing work done to move this vaccine around.

Earlier on, we heard from Dr. Henry that the message was to stick to your ‘local mountain’ if you want to go skiing. Is Mount Washington local to Victoria? What constitutes ‘sticking to your local community’ in that case?

Dr. Henry has spoken to this—that the risk is not the skiing, or the getting out and being active—it’s the après-ski that puts people at risk.

The Big White outbreak, which is now over a hundred individuals, has largely been because people, once they seem to get on the slopes, lapse back to the days of pre-pandemic where … this is used as an opportunity to have some amazing social encounters.

This is the big concern: no matter where you go to take in the exercise, it’s gotta be the focus on the exercise and you stay in your small bubble.

One of the things I think people have to look at personally is to, you know, what is the likelihood that you're going to be able to just ski and not find yourself exposed? Because of this post-holiday peak, we're probably seeing more people who likely are carrying COVID. So the question is, do you even want to expose yourself to a setting like that?

So from your perspective—as someone providing advice—should Victorians be traveling to Mount Washington?

I think it's a personal decision. We would prefer that, if at all possible, stay closer to home, stay in your bubble.

I know it's tough asking people to give up ... a lot of people live for the ski season. But this year we really need to buy ourselves some time to be able to get the vaccine program rolled out.

I think we still have to recognize that the province has not banned it. What we still have is somewhere between a plea and a request to stay close to home.

Our readers want more granular data about where COVID is on Vancouver Island and which communities the virus is circulating in. Why hasn't the BCCDC local health area breakdown been provided since January 2?

It’s maybe just that [public health staff] are being overwhelmed and trying to deal with things. I know that there was a commitment to get that out. I mean, the one piece I can tell you is that given the post holiday spike, one thing you can do is count on COVID likely being in your community.

I think the message to the public is, you don't have to look far to encounter the virus, so at this point, I would suggest that should not be a means by which you make determinations around how you're going to behave.

We know that individual First Nations on Vancouver Island have released information about how many cases are in their community. What's preventing municipalities from doing the same?

The First Nations are First Nations… we respect their autonomy. We recognize and respect their decisions.

At this point in time, on the direction for the rest of us who are governed by the provincial government, and certainly for those of us in the Ministry of Health, that's the guidance that we follow.

But that doesn't mean we don't work closely with these groups and fully respect their decision-making and will provide support.

Where do teachers stand on the priority list for vaccines?

This is [something] I think your readers are gonna hear a lot more about … once we get past March. Right now, as you're well aware, there has been a list produced by the province where they speak to basically immunizing people who work in healthcare settings, paramedics, and certainly underserved and homeless populations.

It's going to be that next big wave after March, where you'll see the prioritization of essential workers like teachers, and again, I have not seen that list. I think it's being developed right now.

Clearly the province is moving forward on it, but exactly what it's going to look like, that's something that I'm sure you and I will both find out at the same time.

Is there anything you want to add?

The last comment I want to make is why Vancouver Island has done so well: it’s because of not necessarily only the measures of the province … but the population has really taken this to heart.

We would not be where we are if we didn't have a population on this island that really has embraced the idea that these are tough times. But we will tough ‘em out together.