Canadians fly south for shot as US demand falls | Hacker News Reader

Canadians fly south for shot as US demand falls

reuters.com

78 pointsadventured211 comments

The US government paid about $27 per dose and is also willing to pay $40 to the person that puts the shot in your arm if your insurance doesn’t cover it fully.

Two shots costs about $130. If you fly to the US and spend any reasonable amount of money, the government has come out ahead with all the taxes you’ve paid on your spending, especially since you need to stay a full month to get both shots.

This isn’t a scandal, and people shouldn’t feel bad about it.

Do you really need to stay a full month?

I thought people would fly, get the shot, then fly back home until it's time to get the second one. Otherwise it seems like it would be very expensive, might need to go back to work, etc.

I’m not sure exactly how that would work. Aren’t there required quarantine periods on both sides? There are a lot of taxes built into the price of the flights, so it would probably still be “profitable” to the US if that is all you did. You’ll need transportation to and from the airport, you’ll probably need to eat a meal or two, etc. And if half the people stay for a month and make a vacation out of it, that more than covers the other half that fly in and out.

The cynic in me says that government officials did the math and figure that it is a great economic boost to allow people to fly in and get a “free” vaccination. I mean, seriously, the government bought something like 2 billion doses for a population of 350 million.

Around me, the Pfizer shot seems to be most common, and wherever you go will schedule your second dose for three weeks later. If you get a Moderna shot, they schedule you for four weeks out.

For reference: https://howfarbehindiscanada.com/

Canada was hovering around 35-40th in the world for doses administered per capita until the USA "loaned" us 1.5M doses of AZ; now we're steady around 15th place, but well behind countries like the USA and UK.

Fifth out of 37 OECD member countries in terms of the percentage of the population vaccinated to date. [1, 2] I don't think either of these metrics is perfect, the ideal metric is what percentage of the old, sick, etc - the vulnerable folks - have been vaccinated.

Point of interest, one thing 4 of the 5 OECD member states above Canada have in common is that they manufacture the vaccine at home.

Considering Canada does not manufacture ([edit] COVID) vaccines, I'd say that Canada is doing very well - top quintile of the OECD pack. Could be better, could be worse.

[edit] I'm actually surprised how close Canada's vaccination rate is to the US - 35% vs 45%. Given all the critical press, I'd assume the discrepancy was much larger.

[1] https://ourworldindata.org/covid-vaccinations

[2] https://imgur.com/a/XlL2J12

> Point of interest, one thing 4 of the 5 OECD member states above Canada have in common is that they manufacture the vaccine at home.

That's smart. Why did the current administration decide not to do it in Canada?

Current administration? Developing a vaccine supply chain takes a very long time, it's not like firing up a tire factory. Trudeau's Liberals have held office for 5 years, with Harper's Conservatives holding office from 2006-2015.

I think without pointing fingers, the COVID situation has shown the world just how fragile global supply chains are in times of stress. The US learned this lesson with PPE, if you remember that debacle.

Hopefully Canada invests in such capacity moving forward.

Canada produces lots of vaccines -- we just happen to not produce any COVID-19 vaccines.

Connought Labs, once a Crown Corporation, was sold to Sanofi who continues to operate the campus in Toronto, and GSK has a campus in Ste Foy [1]. Neither Sanofi nor GSK were able to develop a COVID vaccine in time and their facilities could not be re-tooled to produce the vaccines that we do have. There is not sufficient capacity to take on this challenge at this time, as to your point, those facilities are occupied producing other necessary drugs and vaccines.

Canada was once a dominant player in the vaccine game, but those days are long since passed, especially after the privatization of Connought under Mulroney.

In my opinion this would be a good opportunity to revisit a Crown Corporation devoted to vaccine development, as it does appear the public sector is not well set up to cater to this national security need. We are just 38M people after all. Maybe under the NRC?

[1] https://www.cbc.ca/news/politics/domestic-vaccine-manufactur...

Not every country has the capacity and ability to manufacture everything locally. With increased globalisation we're also seeing countries specializing in certain industries.

Generally it was understood that most western countries would not abuse this dependency for their own benefit, as they all were counter-dependent on each other. Obviously, as so often, the US and UK didn't get that memo.

Most reasonably large developed countries probably have the capacity if they care enough - for example, I don't think the UK was particularly well-equipped to do local vaccine manufacturing, most of the pharmaceutical industry here buggered off to other countries long ago along with the other manufacturing, but the government cared enough (and distrusted the US enough) to insist on local production anyway.

Yup, Canada privatized Connought labs under Mulroney in the 80s. I think with a population of 38M and a private sector not particularly equipped to provide this service, revisiting a Crown Corporation might not be a bad path forward. [1]

[1] https://en.wikipedia.org/wiki/Connaught_Laboratories

>Obviously, as so often, the US and UK didn't get that memo.

There is and has never been a US vaccine export ban, and the US has not seized vaccines meant for other countries.

The Trump administration last year signed gigantic contracts for every planned vaccine, because no one knew which ones would work. Like, enough for every American from one manufacturer, let alone the current four major available ones. More importantly, the contracts guaranteed the US the earliest deliveries.

The UK signed a similar contract for the AstraZeneca vaccine. The EU and Canada did not assure themselves of such quantities. Canada also bet on CanSino because it was afraid that the US would ban vaccine exports (which, again, never happened). Of course, the Chinese did not live up to the contract.

Before you say "But what about—", the Trump executive order from December 2020 merely sets up the legal framework to prohibit exports if desired. But that does not mean that the framework is invoked. Let me repeat: The US signed contracts that were a) huge in size/scope and b) from every pharmaceutical company working on a vaccine, which c) got the country the largest and among the first deliveries. The UK did the same thing with the AstraZeneca vaccine, and spent a lot of money to retool domestic plants to produce it.

If the situation were different, might the US have implemented a ban on exports, similar to what the EU did implement recently? Perhaps. But, fortunately, the US never faced this issue, because of the huge amounts of money it invested a year ago and the contracts it signed with said money.

Then why do we keep hearing about this "export ban"? Who would benefit from spreading this misinformation?

People who want to make America look bad, and drive wedges between America and allies. These social media disinformation campaigns have been going on for a long time.

Who benefits? China, Russia, etc.

Why spend time questioning why China is not being as cooperative as they should with the origin and other important details of the virus when they can make Germans hate Brits and Canadians hate Americans over vaccine exports?

EU did a 300 m dose purchase agreement with Pfizer with a big up front down payment at about the same time the US and UK deals were being made.

The EU also spent the most time negotiating down prices. It's not surprising we're last in line.

> I'm actually surprised how close Canada's vaccination rate is to the US - 35% vs 45%.

The comparison is deceptive, since most of those 45% of Americans have finished two doses (apparently 32% as of May 4 [1]) while very few of the Canadians have (3% [2]). In other words, we've put a fair bit less than half as many shots in arms per person.

[1] https://www.npr.org/sections/health-shots/2021/01/28/9609011...

[2] https://www.npr.org/sections/health-shots/2021/01/28/9609011...

Yes, however, there's no evidence that's less effective in the near term, and there's mounting evidence that spreading out the second dose is as effective - or more so. [1] So I guess it depends on what you're trying to measure.

tl;dr: is that spreading out the dosage of Moderna vaccine to 9-15 weeks actually makes it a more effective vaccine. Spreading out Pfizer, more relevant to Canada, also reduces the number of hospitalizations and deaths over the recommended schedule. [1]

[1] https://journals.plos.org/plosbiology/article?id=10.1371/jou...

Your reference is a modeling exercise and says nothing about vaccine effectiveness in an individual.

There's individual data, too. [1] There's a lot of data coming out about this and it's pretty much a trade-off. You get more people some level of immunity, reducing spread, and you improve the quality of the immunity with a delayed dose vs. immediate turn.

  The results of this primary analysis of two doses of ChAdOx1 nCoV-19 were consistent with those seen in the interim analysis of the trials and confirm that the vaccine is efficacious, with results varying by dose interval in exploratory analyses. A 3-month dose interval might have advantages over a programme with a short dose interval for roll-out of a pandemic vaccine to protect the largest number of individuals in the population as early as possible when supplies are scarce, while also improving protection after receiving a second dose.

There's a lot of work going on now to study this, and the results coming out are all pointing at this being a pretty good path forward.

[1] https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

I mean sure, that might all be true (I'm pretty hesitant to buy it but it's not like my opinion matters, they're doing it regardless), but you said you were surprised at it and this is why it looks that way.

Either way, though, the US is either considerably or extremely ahead of us still.

I'm actually surprised how close Canada's vaccination rate is to the US

That's because you're looking at first doses only. The numbers for fully vaccinated residents are very different -- Canada's policy is explicitly "we don't have enough vaccine to give everyone two doses yet, so we're going to give first doses first and second doses up to 4 months later".

As I posted elsewhere with references the data shows that’s actually preferable. You get better quality immunity and reduce the number of deaths and hospitalizations by waiting 9-15 weeks vs the prescribed 4. [1]

[1] https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

> USA "loaned" us 1.5M doses of AZ

USA has no choice. By agreement, USA cannot give vaccines to someone else, as the indemnity agreements ("can't be sued") don't transfer.

USA could have modified their agreements with the manufacturer of AZ so that they could fill their agreements with other countries before the usa one destined for a warehouse the usa had no intention to use.

Or just get canada to agree to the terms. Pretty sure canada has already agreed to similar terms elsewhere.

I don't think the AZ doses really did a lot for getting Canada there? It was mostly Phizer finally starting to deliver. We've been getting that much Phizer every 1-2wks for a while now.

Current make-up of delivered doses is:

  Phizer: 11m
  Moderna: 3.5m
  AZ: 2.3m

The gap between 15th place and 40th place is pretty small -- it's essentially a many-way tie between EU countries.

And for the record, Canada is above the entire EU pack. [edit] I originally said "except the UK" but uh, well, we all know what happened there.

Canada is only 15th because they aren't doing a 2nd dose until 4 months later. So you can't compare Canada to places that are actually scheduling the 2nd shot properly. NO ONE is getting their second shot. That's a complete hack because Pfizer and Moderna both said not to push the 2nd shot past their recommended time period.

If Canada did their 2nd dose in the 3-4 weeks as required by Pfizer and Moderna, their rank would drop precipitously.

Personally I understand what they are doing, they are going breadth first to slow down the spread, but I hate the propaganda that is saying that somehow Canada is doing "great". They aren't. They completely bundled the vaccine.

Is the goal of the vaccine not to slow/stop the spread? If Canadians end up needing a third shot some time down the line, but the first one spread out does it's job, isn't that ok? Far from bungled, I'd say they made the best of what they had.

I don’t know that anyone has said Canada is going great on vaccination, especially compared to its neighbor.

The delayed 2nd shot is a resourceful strategy (also employed in the UK) to get higher population immunity from fewer shots in the short term.

Vaccine makers have little incentive to recommend dosing intervals different than what they they ran in their studies, but I have yet to see a shred of evidence indicating that mRNA vaccines lose much effectiveness after 3-4 weeks and some evidence that effectiveness keeps increasing. I wish the US had used the single-dose strategy for anyone under 65 as I think our cases would've started shrinking much earlier than they actually have.

> NO ONE is getting their second shot

This is false. The numbers might be small, but people are certainly getting and have already gotten their second doses in the last couple months.

Not just Canadians, I know several Mexicans who have gone to the US to be vaccinated too. Obviously the trip is prohibitively expensive for most Mexicans, but middle class Mexicans can probably afford it. (I'm patiently waiting my turn here in Mexico City, though.)

Upper class Mexicans*

Well, I doubt the ones I know that went to the us for vaccines consider themselves upper class. I guess it depends on how you define the term. The distribution of wealth is absolutely terrible here in Mexico. I'm a junior professor at a large public university, I have a wife and son and am our family's only source of income. According to the government's statistics my income of approximately 25K USD a year puts our family above the income of 90% percent of all families of 3. I guess that 90% figure might justify you calling me "upper class", but I think the lifestyle afforded to us by my university professor's salary is much more in line with what is considered "middle class" than what people think of as "upper class". From what I can see of my American colleagues, a junior university professor in the US has a pretty comparable lifestyle, and they don't consider themselves upper class either, I believe.

I won't do it, but I could certainly afford to fly with my wife and son to the US to get vaccinated (and, as many middle class Mexicans, all 3 of us already have American tourist visas). It would maybe cut into our savings a little more than I'd like, but we could do it.

I think the people I personally know that went to the US to get vaccinated are in a roughly similar boat to our family, maybe a little better off, but I don't think of them as upper class either.

I think your class is inherently related to your wealth/income relative to your peers in your country. The 50th percentile Mexicans are not the ones going to the US to get vaxxed.

> I think your class is inherently related to your wealth/income relative to your peers in your country.

I'm not sure that completely tracks with the way I hear the term "clase media" used here, however I very strongly agree with the other thing you said:

> The 50th percentile Mexicans are not the ones going to the US to get vaxxed.

The widely used definition of middle class isn't simply "median income". It's more complicated than that - education, profession etc all play into it. You could probably segment it by income, but even then median isn't the right measure.

Okay, how should "middle class" be segmented by income?

I've always understood middle to mean... well, the middle of the distribution.

My wife, in Australia (I'm in the USA; we saw each other over Christmas but we've been otherwise involuntarily separated since January 2020), could get the shot here on our medical coverage ... if only Australia would actually let her leave the country.

She's not free to leave the country? That's surprising.

Correct. There is a mandatory quarantine on arrival, but Australia is very unusual in nonetheless not allowing Australians to leave the country under normal circumstances. You have to (for example) be able to prove that you will be away for more than three months.

Just saw this reply. Wow, that's amazing. I've never heard of anything like that in a Western country.

I see people saying this getting downvoted but I have to add to the voices: I'm disappointed in Canada. I recall the subtle pride Canadians showed early on in the pandemic when our rates were comparatively low and when we secured massive orders of vaccines. I even remember some subtle Facebook teasing about how the US could learn a thing or two from us.

Nearly all of my US colleagues have received both doses of vaccine. Yet, hardly anyone I know in my age group in Canada has even received a single dose (only those in front-line positions). The current debate is that there will likely be up to a 4 months wait to get the second dose for those lucky enough to have gotten the first.

I registered once my age group was made available on April 20th and I have yet to receive the notice that I am able to book an appointment. It is frustrating as even now they are announcing stricter lockdown measures including checkpoints on highways between provincial regions.

Part of my disappointment is I feel Canada was taken advantage of and our government let it happen. Other countries are willing to take our orders for vaccines and our money, but they don't worry too much about just delaying shipment. The Canadian government has been unable to do anything about that. Maybe our international reputation as being "nice" plays into it.

I can't say that I am angry, more disappointed and frustrated.

> It is frustrating as even now they are announcing stricter lockdown measures including checkpoints on highways between provincial regions.

Is that serious? It has to be satire. I would expect that from places like Cuba, not a western democracy.

Video for reference: https://www.youtube.com/watch?v=8esnpGdkyY0

What reggieband mentions began very early in the lockdown process: See the Atlantic bubble (https://en.wikipedia.org/wiki/Atlantic_Bubble).

Individual Australian states did the same thing. There such a thing is effective because only a handful of highway connections exist between states, and there is effectively no way for people to cross the desert outside the border crossings. It's not nearly as effective in Canada and, aside from constitutional issues, would be completely ineffective anywhere in the 48 contiguous states; even the most rural states have hundreds of interstate road connections, and it's possible to cross on your own almost anywhere else.

I mean, France currently has a 7 PM curfew and until 3 days ago was restricting people to their own region and within 10 km of their residence: https://www.reuters.com/world/europe/french-pm-confirms-covi...

BC is blocking off traffic from AB

Isn't it a lot more efficient to ship the doses north than the Canadians south?

It would be, but the US has an export ban on covid vaccines, just like the UK does.

https://www.reuters.com/business/healthcare-pharmaceuticals/...

Already shipping to Mexico, about to start shipping to Canada.

Pretty much half a year later than originally agreed. Considering this 6 month delay in vaccine availability, it's incredible how well most countries held up.

They're taking over what belgium was shipping us, but not increasing the amount. So its not exactly team usa here to save the day.

Afaik, the UK does not have an export ban [0] I would be interested for a source if that has changed.

[0] https://www.politico.eu/article/why-the-uk-doesnt-need-a-cor...

The UK doesn't have a technical export ban, just a contractual requirement that all UK manufacturers have to first supply all UK contracts before supplying any export contracts. Even though the UK contracts were signed after other contracts.

Whether that's an "export ban" or not is semantics, the result is the same: nothing is exported.

So. It turns out that the EU propaganda may have been just as misleading about US vaccine exports as everything else - although no finished vaccines came from the US, apparently a good chunk of the raw drug substance which AstraZeneca packaged up into vaccines from the EU market was imported from the US early on: https://www.politico.eu/article/astrazeneca-vaccine-shortfal...

>So. It turns out that the EU propaganda may have been just as misleading about US vaccine exports as everything else - although no finished vaccines came from the US, apparently a good chunk of the raw drug substance which AstraZeneca packaged up into vaccines from the EU market was imported from the US early on

Yes. The EU didn't ban vaccine exports to the US because it was afraid that the US would in turn stop the component supply chain that European plants need to function.

There is no such thing as an export ban.

Pretty sure we would even be willing to come down to pick them up ourselves for transport!

It would be great to get perspective from Canadians on the case. Why is Canada, a country with wealth, in the current situation?

national health agency failure in planning?

supply chain constraints?

Import constraints (even though there are plenty across the border?)?

Something else?

The US doesn't export any COVID vaccines. Neither does the UK. Pretty much the entire rest of the world is supplied by Belgium, the Netherlands and Germany. (Russia and China are exceptions in that they have their own, separate vaccines).

Russia's exporting theirs: https://www.statista.com/statistics/1123927/sputnik-v-export...

China's also exporting their sinovac vaccine

That's correct, but Russia's vaccine isn't approved in most countries as every batch so far has had very unreliable QC with significantly different results.

As I said, those are exceptions, the vast majority has no option other than to wait for the US to slowly start exporting, or use the european sources.

This article indicates the US is exporting vaccines: https://www.reuters.com/business/healthcare-pharmaceuticals/...

We discussed this already in our other comment chain in this thread :)

Yes. I just think it's important to have accurate information.

I’m sure you’ll see that change as J&J ramps up.

The supply chain around Pfizer is very difficult. Export beyond Canada in volume sounds like a tough proposition (it requires a dry ice cold chain). But.. two dose requirements don’t work for hesitant populations, which is where the US is now.

I would guess that US demand for Pfizer will drop and exports of Pfizer to Canada will happen as J&J is deployed more. (At least until kids can get Pfizer)

1. We do not have our own plants capable of producing covid vaccines. 2. United States stopped all vaccine exports. We got all vaccines from Europe. 3. We did not pay producers through the nose like UK or Israel did which affected our place in the queue. 4. Production scale ups and problems in January-February slowed down the shipments significantly relative to what was promised by producers.

> 3. We did not pay producers through the nose like UK or Israel did which affected our place in the queue.

This is obviously a huge mistake when the vaccines basically pay for themselves.

Same mistake the EU made. Very little understanding of what they're actually getting.

Although from what i understand you had to buy them before they figured out if they worked. So either hope you get lucky with what one you buy, or pay through the nose for all of them which is cost prohibitive.

Cost prohibitive but still net revenue positive to governments, even with that uncertainty.

>2. United States stopped all vaccine exports.

There has never been a US vaccine ban (see my comment elsewhere). The US did, in fact, pay every pharmaceutical company with a vaccine in development huge amounts of money for enough doses for the entire country from each company. Basically, the US was the firstest with the mostest.

>We got all vaccines from Europe.

... because Canada's bet on CanSino failed.

Short answer: import constraints.

Canada, like many countries, does not have the capacity to manufacture vaccines at scale. Our vaccine supply comes from over seas. Up to now the United States has not allowed vaccines to be exported to other countries so most of them come from Europe.

Canada's bureaucrats & credentialled-positions are too far removed from competition / market pressure.

The decisions & results reflect this.

>national health agency failure in planning?

>supply chain constraints?

Those two mainly. We don't have the supply to vaccinate efficiently and the health agency has had poor reaction to the virus and poor planning in the past for these kinds of events.

Isn't canada third per capita of G8 countries in terms of vaccine?

Canada is roughly in the same situation as every wealthy country that isn't usa, uk or israel (excluding tiny countries).

In addition to the supply constraint that has also been mentioned, there is a lack of political will to target vaccines in the hot spots.

In Canada, health care delivery is a Provincial responsibility. However, the Federal government is the one procuring the vaccine doses. The Feds are distributing doses to the provinces based on the population-based formula all the Provinces could agree to. And the Provinces are then incentivized to get into arms locally to show they're doing something.

It appears there is no political will or strong enough incentives available to change the dose distribution to be "needs-based".

The result is that we're unable to target vaccination to the cities and provinces that need it most, so those places are now responding with a 3rd wave of lock downs to prevent the spike in hospitalizations.

In other words, all of the provinces are getting it equally, but most of the demand is in the big cities, esp. the GTA area where like 40% of Canadians live.

Not quite - They're getting it equal based on population (https://en.wikipedia.org/wiki/Template:COVID-19_pandemic_dat...). Ontario and QB are getting far more doses than Nova Scotia, for example. But the hot spots are in some major cities and there appears to be no way to divert the NS vaccine to the GTA, even for a short time.

And demand isn't in all of the big cities. Just the ones where the provincial governments went early on removing all restrictions on high-contagion events (ie. indoor dining & church-service-like indoor gatherings). Montreal had the largest outbreak per capita of the second wave, and they're doing fine right now because they didn't do these things.

And, Ontario itself is only about 38% population of Canada. The GTA is about 18%. Large, but not close to half.

My best guess:

1. We don't have enough pharma industry to manufacture our own supply. The founder and CEO of the largest Canada HQ'd pharma company was assassinated in 2017 and I'm sure that didn't help.

2. All of the U.S. supply was essentially created under the Trump admin. We were having a mini trade war and enforcing strong border control through that time. In more normal times we probably would have piggybacked on the American supply.

I think that is why our overall progress is more comparable to Europe and not the US.

>The founder and CEO of the largest Canada HQ'd pharma company

https://en.wikipedia.org/wiki/Barry_Sherman

Holy shit, billionaire assassinated in his own home, ongoing investigation but no real leads.

Canada was simply too late for everything. Wait and see, wait and see, whoops - it is too late. I also suspect that Canada’s low early infection numbers were results of non existing testing.

I'm Canadian and I have been seriously considering moving to the US for a few months now. It may just be "grass is always greener" but after some initial criticism, it seems like the US has handled this so much better than we have, people are getting back to normal there while our governments continue to add restrictions. I didn't realize we were only at 3% vaccinated, but that is an absolute embarrassment. I'd be curious to hear American or other outside perception of how we have handled it.

American viewpoints all fall pretty much along political idealogical lines with when it all went wrong but I think that most Americans agree that America is “doing terrible” and the only real debate is who is to blame. Shitting on America has become America’s past time and any kind of national pride is met with staunch criticism or “cancellation.” I think your viewpoint is somewhat a “grass is greener” viewpoint being Canadian and any particular American’s view on Canada’s response will be in line with their political party.

Objectively we are probably doing the best in the world at vaccinating such a large and diverse population. You’ll never hear one of us admit it though and if you do then you can be sure to hear it followed up with a “but” denigrating ourselves in some other way. Objectively Canada is doing terribly at vaccination and it boggles the mind that your country is still having to impose strict lockdowns and go off the label with dosing timelines because of your inability to secure a supply.

example of your point on politicized viewpoints: Ericson2314's comment in this thread

The 3% is people who have had both doses. If you live in Canada, then you know that almost nobody has had both doses. That's not our priority - maximizing collective protection is the short-term goal.

Personally, I'll measure Canada's performance throughout this pandemic by the final number of per-capita deaths. We're hardly best in the world but doing a lot better than the US so far (1,783/M vs 643/M at the moment[0]).

[0] https://www.worldometers.info/coronavirus/

Edit to add: Canada could easily take the lead over US in deaths/M if US get's vaccinated faster/better. I'm not so naive to believe that's impossible. It does seem Canada has a strategy to avoid that. Otherwise, it simply seems too early to call either way.

>Personally, I'll measure Canada's performance throughout this pandemic by the final number of per-capita deaths.

How about in relation to the cost & externalities of this per-capita death figure? Financially, socially etc.

It's as though there's no adults in the room willing to speak to tradeoffs - the pernicious, long-term 2nd+ order consequences to be considered.

There are plenty of adults in the room willing to discuss tradeoffs. But you need numbers, and many of the people who don't like lockdowns prefer to make nebulous references to tradeoffs rather than discussing direct harm.

There's extensive evidence suggesting that many of the economic effects of the early pandemic were entirely independent of whether a choice was made to lockdown. Individual people aren't stupid and they're not going to keep going out and consuming while a deadly pandemic is raging.

>There's extensive evidence suggesting that many of the economic effects of the early pandemic were entirely independent of whether a choice was made to lockdown.

Remove choice from business owners & watch effected industries move elsewhere (texas, flordia).

>"Individual people aren't stupid and they're not going to keep going out and consuming while a deadly pandemic is raging."

Covid is 'deadly' to the overweight & immunocompromised.

affected* florida*

And yeah, I'll wait and see.

> Covid is 'deadly' to the overweight & immunocompromised.

Oh and what percent of our population is overweight again?

Not going to continue this conversation, enough of the usual covid canards that I can tell it wouldn't be worth it.

>affected* florida*

Did these typos affect your ability to parse my comment? :)

>Oh and what percent of our population is overweight again?

What's your point?

It's hard to talk about numbers like that, especially before they happened.

I know in Philadelphia, the murder rate is up about 40%. When I was looking at deaths data from the CDC, I found that deaths were up (from 2% on average increase) substantially. I dont remember the % increase, but I do remember 40% of the deaths were not directly from covid-19. if those numbers remained consistent, about 400k extra people died this year from other causes.

that 400k, its hard to tell where 'they would have died as a direct result of covis19' and 'lockdowns caused it' begins and ends, but that is not a nebulous number, and its not a small one.

And honestly, I dont care about how many would have died vs this and that, back off our freedoms. No one, for any reason, should be able to tell us we can't go outside, can't have family gatherings, can't run a business, etc. No one, for any reason even if the death rate was 100%. And HIV is 100% fatal, yet no one ever required showing someone their HIV status on an app before having sex.

So 50 additional murders in Philly, and uh 3500 covid deaths. Yeah, wonder where the cost-benefit analysis lies on that one.

Moreover, I'm not convinced the economy wouldn't have declined if we hadn't locked down - consumers changed their behavior even in places that didn't lock down. The economic decline is likely behind the increase in murders (along with school closures).

> if those numbers remained consistent, about 400k extra people died this year from other causes.

I'd love to see a source, as I haven't seen a single bit of evidence suggesting anything like that.

you are focusing on the 50 and not the 400,000. so now that you established yourself as a troll, I really dont care to convince you of anything.

> "I'm not convinced the economy wouldn't have declined if we hadn't locked down"

I didnt say the economic decline is solely linked to the lock downs, I dont think anyone ever has. however, no one with half a brain would ever argue the lockdowns were so much worse.

> "The economic decline is likely behind the increase in murders"

Not likely, the last severe economic decline (great recession) didnt see such large spikes in violence. school closures are part of the lock-down.

> "I'd love to see a source, as I haven't seen a single bit of evidence suggesting anything like that."

That data is freely available from cdc.gov

>Personally, I'll measure Canada's performance throughout this pandemic by the final number of per-capita deaths.

That doesn't seem like a good measure. At the extreme, enforcing a stay-at-home order would make this number 0, but a lot of people would argue this wasn't "good performance."

Australia has 9 doses per 100 compared to Canada's ~30. Based on your metric, Australia would be a failure.

Australia was a clear success case.

Number of deaths per capita should absolutely be the primary metric we are using to judge pandemic success.

>Australia has 9 doses per 100 compared to Canada's ~30.

I'm not sure what you are saying, doses of vaccines?

Number of deaths per capita don't take QoL into account over the period you analyze and the response's effect in the future.

Doses of vaccine, yes.

I'm curious, what QoL increase makes up for 400k additional deaths over Canada's number?

>Doses of vaccine, yes.

I have not claimed doses of vaccine to be a good metric.

>I'm curious, what QoL increase makes up for 400k additional deaths over Canada's number?

Who has 400k more?

You also have to take into account that policy differences do not solely explain the difference in death toll. Saying 400k more death over canada = canada good response is a reductionist view when there are other factors in play.

Okay, so what does explain the difference in death toll? I certainly don't think it is only policy diffferences.

> Who has 400k more?

If we had Canada's per capita rate, 400k fewer people would have died.

I am not familiar with Australia's response enough to give a conjecture on how good its policy is. Although I am familiar with Canada's response and (independently of death toll) think it was very suboptimal.

>I certainly don't think it is only policy diffferences.

And I agree with you, which is why I think using death toll as a single metric is a bad idea.

EDIT:

>If we had Canada's per capita rate, 400k fewer people would have died.

Even with the same policy as Canada, it is unlikely that the death toll would just transpose (it's a bad assumption, because policy doesn't define the death toll - it affects it)

With the vast majority of people who died in first world counties already being close to deaths door I don't think that's a good stat maybe something more like total estimated years of life lost.

Estimates for average life lost per covid death is around ~15 years. Sure, it killed plenty of old people, but it also killed plenty of middle aged/older middle aged people that had plenty of time left.

But I'll cede to you that YLL is also a good metric. When comparing two developed nations like Canada and US, most of the difference there will probably be explained by per capita deaths though.

>Estimates for average life lost per covid death is around ~15 years

Source?

https://www.nature.com/articles/s41598-021-83040-3

I also saw a US specific article but can't find it off the top of my head.

As someone getting up there in age, it's kind of shocking how cavalier a few people seem to be about old people dying from COVID. "Close to death's door?" Years of Life Lost as a measurement? Really? It's like we're living in Logan's Run. My parents are elderly but they might just live for 25 more years--who knows? If they or someone else's grandparents were to die of COVID it would be no less tragic than if a 30 year old died of it.

I don't think we should be cavalier about the deaths of elderly and I generally agree with you about the rhetoric, but I can't say I really agree about the "no less tragic" comment.

I think the point is we have up to 80,000 flu deaths each year in the US. If Covid never happened and 80,000 people died of the flu nobody would bat an eye.

You talk like the big ongoing campaign to increase flu vaccination rates is some sort of accident.

Yes, because we knew how to deal with 80k. Suddenly we had to deal with 400k, which is a much larger number.

Not only are you 100% correct, but anyone thinking otherwise has the luxury of not being born poor or a minority based on how deaths are working out in first world countries.

It's certainly not the only measure. But I'd argue it's one of the best I have available. (Wishing we had metrics or data which we don't actually have doesn't count for much)

If you don't have a good metric to measure something with, relying on a bad one is arguably harmful as it gives a false sense of authority/trust.

The metric can still be used in extensive studies (that take nuance into account), but using it as a metric on its own is fallacious imo.

"At the extreme, enforcing a stay-at-home order would make this number 0" I don't think this is true.

If a tornado comes through town and hits my house and doesn't hit yours, it doesn't mean your preparation is what saved you. Canada did nothing exceptional or faster in the 1st quarter of 2020 that would merit such a pat on the back.

I'm not sure how to respond to this other than to say it is patently untrue.

Not least, Canada had a government that admitted the virus existed and might be a problem. Following that, we had a coordinated national effort to combat it rather than a laissez-faire approach of letting every state do as they please (which often meant nothing at all in many states).

Canada's approach was hardly bullet-proof but claiming the countries' responses were identical could not be further from the truth.

This isn’t accurate at all. Each province was pretty much doing their own thing. BC didn’t even have a mask mandate until late last year.

The federal govt requires a quarantine when arriving by plane but thousands have said “no” (how is that possible) and been threatened with a fine that costs the same or slightly more than quarantine.

It’s been a major cock up.

>Following that, we had a coordinated national effort to combat it rather than a laissez-faire approach of letting every state do as they please (which often meant nothing at all in many states).

As refurb said, this is completely wrong. Canada is decentralized (yes, including its healthcare system) like the US. Ottawa didn't mandate the Atlantic Bubble (https://en.wikipedia.org/wiki/Atlantic_Bubble), for example; the Atlantic provinces set it up on their own. Ontario's recent lockdown—far stricter than occurred anywhere in the US, as I understand it—is just that, in Ontario.

Canada needs more competition in the health care industry.

There's very little.

Instead I see rent seeking, nepotism, resting on credentials, signalling..

Canadian health care is attracting worse & worse (in terms of competence & care) people every year.

US did ~~everything~~ many, many things wrong, except the one thing we know to do --- throw money at medical problems --- actually works for vaccines because vaccines are such a phenomenal piece of technology.

Looks like vaccine IP restriction lifting is finally going to happen. I would stay put in non-US places.

>US did everything wrong, except the one thing we know to do

Such a political take. The US did a lot right.

I scaled it back for less pathos, but tell me this: if there weren't vaccines we would not be completely screwed?

We absolutely had no effective backup plan, but also weren't completely honest about relying so heavily on vaccines.

(Now again vaccines are great, so that's not the worst plan, but what I'm getting it was it wasn't really the plan at all. We were screwing up by the measure of our own goals rather than intentionally waiting for the big bailout.)

----

Also East Asia is mopping the floor. There's truly very little good to say about EU let alone US in comparison.

> if there weren't vaccines we would not be completely screwed?

Probably not. The infection and death rates were plummeting even before general availability of the vaccine. States that locked down super hard, and states that barely locked down at all, have essentially the same infection/death rates as well.

The US is a big country, with a lot of people. However, the average health of an individual in the US is far better than the East Asia area, and much of the world. That's before we even consider the vast young population in the US which mostly are asymptomatic infectees...

The number of people who have been infected already and cannot become infected again with the same variant is likely massive in the US, making it quite possible the US would have weathered even the latest variants due to a lack of infectible people (ie. "herd immunity").

The “US” means many things.

We have tiered lockdowns all over the place, rent protections, paycheck protections, massively improved digital services from Google, Zoom, etc. Just the digital services alone have enabled home schooling and home working for a good chunk of the world.

I wouldn’t call this nothing.

Our media (US that is) seems to pick and choose which counties are "handing it well" seemly with little regard to statistics. Canada has largely been portrayed as handling the whole situation very well and if you polled random people on the street of a US city I'd be willing to bet quite a bit they think your vaccine rates are comparable or better then the US.

It depends on whether you only get your info from MSM or get info from new media. From the latter I've seen a lot of stories about the police acting gestapo like with arrests for non-masking, gatherings etc. So, my view is certainly not positive when it comes to Canada but I'm sure you're correct when it comes to the average citizen.

Which is where the whole politicizing the pandemic comes into place. Canada's vaccine roll out has been complete garbage. Which is mostly because we didn't make our own vaccine (didn't have facilities) and are relying on other countries to give it to us.

India was able to make their own vaccine and so far vaccinated 158M single and 29.1M fully. US 248M and 106M fully. Yet Canada wasn't able to make their own and so far only 14M single and 1M fully.

They won't say it publicly but I'm guessing the real strategy at this point is keep restriction going through the summer and they have worked out a deals with the US where they (and Mexico probably) will get first dibs on all the US's extra stockpile.

Canada was handling it well (or just lucky) until this past Q4.

I have friends in BC. For a population of 5 million they had around 2,000 cases in September. Now? 130,000 cases. They got complacent, people let their guards down, it exploded.

Honestly, in this case, think it just comes down to money. Whatever the other problems with the American handling of it (and my god was it disorganized) The US also threw 800-pound-gorilla levels of cash at the manufacturers, and since the vaccines turned out to be good, it worked out. Smaller economies just didn't have that as an option, whether the policy-makers wanted it or not.

Canada is at 3% fully vaccinated, with both doses (almost all the vaccination has been with 2 dose vaccines). However, 35% have received one dose out of two.

Canada could have chosen to vaccinate about 15% of the population fully, which would have been enough for the supermajority of the >65 population that is responsible for almost all of the deaths. But we chose not to. Whether or not that is the right choice remains to be seen.

I thought Canada was handling COVID well and then there was the latest round of lockdowns and restrictions which is bonkers.

It seems like Canada is prioritizing a "first dose first" strategy, so I think the 34% number should be compared with the 56% in the US.

The US has done very well with vaccines so far, but in terms of (in my view) the real number for success (deaths per capita), the US has had 3x as many.

The vaccine rollout has been great in the US. The anti-masking and politicizing of the pandemic has been terrible.

I guess the deaths per capita will be fairly high in the US but it varies a lot from place to place. Many places did very little lockdown and more-or-less carried on with life as usual.

Your country's response to COVID frankly terrifies me. The police showing up and arresting maskless people, shutting down businesses, raiding churches. The vaccine response seems piss poor as well.

I realize the media sensationalizes a lot of this but from the outside it doesn't look good. I know the US is seen as not doing enough but I prefer that over the authoritarian responses.

We certainly have our issues but for now we still hold people's personal freedoms at a high level. I live in a somewhat rural area but I haven't had to wear a mask in most places for about a month, I've been vaccinated for over a month and I've been out enjoying beers etc. like normal for the last several weeks.

Funny how people don't like your comment. It terrifies me too. I assumed I was in a free country, and it had all gone so bad so quickly. Thus wanting to get into a different country that hopefully has stronger notions of personal freedom..

They don't like it because they think I'm sharing fake news because our MSM will not report this. If you look at the other comments here they believe the Canadian response is one of the best.

Obviously, I don't live there so I'm open to changing my mind. I've just read some stories that don't sit well with me coming out of Canada and even if they're in the minority they should still be addressed.

I thought you were talking about the US in the first paragraph. In truth, there haven't been strong enough enforcement measures in Canada, that's why we're having such a bad third wave right now.

In Alberta, which has the highest case rates in Canada, there have been less than 2 tickets issued per day for violating the restrictions. Until yesterday at least, if you went out you would see people all over the place without masks, hanging out with their friends on patios, having parties, etc.

You say you've been vaccinated for over a month, but we haven't had that privilege. So instead, we have to rely on safety measures like avoiding big gatherings and unsafe behaviour.

The 3% statistic is fairly misleading. Canada has adopted the one-dose first regiment just like the UK. Which means that there is a 4 month difference between 1st and 2nd shot. The rationale was that it would overall save more lives as 1 dose is ~80% effective at preventing hospitalizations/deaths compared to ~95% for two doses. So you vaccinate double the number of people with one dose rather than half the amount with both doses and you save more lives. This was a strategic decision as Canada does not have the vaccination production, unlike the US which has prevented exporting of vaccines.

In Ontario we have 42.5% of all adults with 1 dose. In Ontario we expect ~80% of the population to have 1 dose by June 20th[1]. Which I believe is a really promising statistic, and based on current vaccination trajectory we will meet that date. The 4 month dose stretch is expected to be shrunk to a lot lower once supply has increased sufficiently and most people have 1 dose.

The increasing restrictions was unfortunate but very necessary. In Ontario at least hospitalizations and ICU capacity was getting out of hand at a faster pace than Ontario has seen throughout the pandemic. These numbers spiked in part because the lack of vaccine supply in the early days of vaccinations. Our importing of vaccines was incredibly slow at the beginning of the pandemic, mostly because we had to import from other nations which are already scrounging for vaccines. Now the pace has stepped up dramatically, based on our current jabs in arms per capita we are ~42 days behind USA[2]. Which is not that bad considering Canada has no vaccine production capacity. Excluding micronations we are ranked ~16th in the world.

[1] https://globalnews.ca/news/7679338/ontario-coronavirus-phase... [2] https://www.howfarbehindiscanada.com/

> Canada has adopted the one-dose first regiment

Huh, interesting, TIL.

I was not feeling very confident in the vaccination response seeing that 3% number, but this changes my perception quite a bit.

I do still have questions about the overall handling of pandemic risks though. I recall reading last year that several million masks went to waste because they expired in warehouses, and not having vaccine production facilities despite being aware of the potential risks after SARS seem... suboptimal.

Another Canadian here, planning on moving to Florida or Texas in the future. Severely disappointed and the "police can stop and question at random" by Doug Ford along with the curfew in Quebec is what's breaking the camel's back for me.

Main problem here is that instead of building temporary hospitals to boost the hospital capacity like US did last year, we have simply kept locking down which is equivalent to throwing the problem under a rug. It's been a year and even though they were talking about it last year, only as of couple weeks ago, they are planning on using temporary field hospital in the coming weeks. Why wasn't it used for a year to boost the capacity? Also the 2 temporary hospitals in Ontario have only 73 and 84 beds. That's tiny.

https://toronto.ctvnews.ca/ontario-says-a-covid-19-field-hos...

Then the whole nursing home debacle where the military audit showed reprehensible conditions and caused vast majority of the nursing home deaths:

https://toronto.ctvnews.ca/gut-wrenching-military-report-she...

As an American, here are my thoughts.

From as early as February or March 2020, I had always felt they told us what we needed to know - about 600k people would die of covid-19 in the US. I thought maybe if we did some things we could get that number down, but we failed in that respect. We pretty much had as many deaths as we would have doing nothing.

on a per capita basis, canada did a lot better (600 deaths / mil vs 1800, 32k cases / mil pop vs 94k). +2 Canada, although there are some circumstances that I will get to later.

our deaths per case is about the same, although NYC and NJ skews our numbers. call it a tie.

vaccines, US is a clear winner. +1 US

Freedom wise, its a mixed bag. States like NYC and California did all sorts of lockdown shenanigan's that all failed, where as states like Florida stayed mostly open and did better than the national average case/death wise. I can't really speak to what Canada has done, I'll let you fill this one in.

So in the end, Canda 2: US: 1 + 1 ? going to who wins on freedom. However, the US did have some circumstances that canada did not have.

Latin and South America have been ravaged by cv19, and approximately 1-2 million walk across the border / year illegally. I really don't care if that is 'wrong vs right'. Its important to consider when thinking how the virus is going to play out, and its no surprise that areas with high immigration from those areas did the worst.

Its also why relying on herd immunity here will also never work. Unless we vaccinate Latin and South America (I'm in favor of that), we are going to have plenty of exposure to the virus.

The range was from 500k to 1.2 million if elimination failed, at least in the early estimates I saw. Early in the pandemic, we were woefully underprepared with care - you can see how the death proportion has changed with time.

If we had let the pandemic spread in normal course early on, I suspect we would have seen many more deaths.

I think it is way too easy to look back and say that we had as many deaths as we would have had doing nothing.

> We pretty much had as many deaths as we would have doing nothing.

In the US, 1.8% of cases have resulted in deaths, with 10% of Americans getting sick and tested[0]. The majority of these deaths happening 6 months into the pandemic, i.e. a lot of knowledge had been gained and resources stockpiled.

Doing nothing early in the pandemic would likely have increased the death rate to roughly 3% because of a lack of medial resources (including doctors and nurses), and resulting in 66% of Americans getting sick. Excluding children (i.e. 300 MM US adults) the expected death count would have been 6 MM people.

That said, I feel you, I would have personally hoped that for the effort we did put into "whatever we did", it would have reduced deaths by 100x (i.e. less than 0.06 MM deaths) but sadly we didn't work as a team and people died for it.

However, while it shouldn't even have been 0.6 MM, "whatever we did" roughly decreased the deaths by 10x and thats a worth calling out.

[0] As of May 5th 2021, 32,513,303 cases and 578,500 deaths. https://www.npr.org/sections/health-shots/2020/09/01/8167071...

Of reported cases*, which is very different than actual cases.

CDC actually has a page where they estimate the true number of cases of COVID in the US, and they put it at ~115 million. So that would be 578k deaths / 115M cases, or a fatality rate of ~0.5%, which is roughly in line with what you could have expected based on the early studies from the cruise ships where there was free spread of covid in a contained space.

If medical facilities had been overloaded, we certainly could have seen more fatalities, but beyond protecting the hospitals from running out of beds (which was worthwhile), the other interventions didn't seem to do much.

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...

The quality of the response has greatly varied state by state. Each has/had their own set of restrictions and reopening phase timelines.

California based their lockdown level on ICU capacity per region of the state dictating which businesses could remain open. There was a lot of (warranted) criticism on the specifics because officials seemed to based the list off of necessity rather than potential for harm, which potentially led to the unnecessary killing of many small, locally owned businesses. It didn’t help that we had a few elected officials skirting lockdown regulations by dining out with a large group and going to a high end salon when these things were not allowed at the time.

The first half of the vaccine rollout was rocky. When the first group (medical professionals and 75+ only) had their turn, There were clinics with vaccine that needed to be used because appointments slowed down quickly. It took them weeks to move onto the next group which included people with high risk medical conditions, front line workers, and 65+. The list of qualifying medical conditions was laughably incomplete, e.g. you didn't technically qualify if you just had severe asthma in many counties. Many clinics stopped asking for proof of a qualifying medical condition and let people “self certify.”

I probably only see the bad having to live with consequences of others’ hasty decisions in California but we may have redeemed ourselves, in a small way, in the second half of this vaccine rollout by being able to provide vaccines to anyone over 16 earlier than the goal set by the Biden administration.

From the onset of the pandemic, I don’t think it was massively unreasonable to let states make their own rules but the federal government utterly failed to adequately support people and small businesses. To qualify for the stimulus check, you had to made under the limit according to your 2019 (or 2018 if you did not file yet) tax return. Last time I checked, the pandemic hit us in March of 2020 - so why was this determined by earnings a year earlier? There is a certain set of people in power that will fight to the nail to make sure that nobody receives a benefit if there is even the smallest sliver of a chance that they may not be deserve it, which is an absurdly nonsensical and short-sighted approach to take in the wake of a global pandemic.

Why are so many comments being downvoted for expressing opinions and countering data? Are HN readers beginning to aggressively use the downvote button?

It's a metaproblem that HN doesn't want to address. It creates an echo chamber that isolates dissent. There's a framework in any society, including those online that serves to isolate the higher man. Group think is required.

The particular opinion here is that everyone should get vaccinated. Any other opinion is down voted.

Solution: Downvotes should require an accompanying comment as to why. Downvoting without explanation does nothing to change minds or behavior. It just alienates people.

Ironically, if one gets a downvote without explanation, it only serves to reinforce the opinion of the downvoted commenter.

HN, like every community, and every person has blind spots and this is one of theirs.

I created historical Canada global rank viz for data for following metrics from Our World in Data:

Total doses per 100 people Daily doses per 100 people People vaccinated per 100 people

Includes filters by OECD, G20 and >5m, > 15m and > 30m

They all nicely show the effect of Jan/Feb vaccine supply constraints.

https://sitrucp.github.io/covid_global_vaccinations/

As a canadian, i feel like there is whiplash here. Half the world is criticizing the canadian gov for not procuring enough vaccines fast enough, the other half is saying we're hogging all the vacines preventing equitable distribution with poor countries.

As a Canadian, I always liked our socialist heath-care system but after living through COVID my opinion has completely changed. I live in Toronto and we've been under a lockdown since March 2020! The lockdown was only slightly relaxed in the summer of 2020 for a couple months. Other than that, it's been a continuous lockdown. The health-care system has been lagging way behind the US and it's not close. I personally know people from Toronto who are in Florida right now waiting out the 3 weeks between their 1st and 2nd vaccine dose. Here only people 40+ are eligible for their 1st dose now and can't get their 2nd until August!

What does the socialist healthcare system have to do with government-planned vaccine rollout? If you had a capitalist healthcare system like the US, that would not give you a better vaccine rollout.

> What does the socialist healthcare system have to do with government-planned vaccine rollout?

Maybe you should re-read that sentence

US: 248M doses, 106M fully vaccinated, 32.3% fully vaccinated.

Canada: 14.3M doses, 1.16M fully vaccinated, 3.1% fully vaccinated.

Vaccine companies refused to manufacture vaccines in Canada due to lack of facilities. This is a fact. So Canada is waiting on getting them from other countries.

Despite all the flaws of the US system, US is doing much better than Canada for vaccine roll outs as well as lockdown measures. When USA built temporary hospitals and 2 hospital ships, Canada has yet not done it and it's been a year. Main problem here is that instead of building temporary hospitals to boost the hospital capacity like US did last year, we have simply kept locking down which is equivalent to throwing the problem under a rug. It's been a year and even though they were talking about it last year, only as of couple weeks ago, they are planning on using temporary field hospital in the coming weeks. Why wasn't it used for a year to boost the capacity? Also the 2 temporary hospitals in Ontario have only 73 and 84 beds. That's tiny.

https://toronto.ctvnews.ca/ontario-says-a-covid-19-field-hos...

> If you had a capitalist healthcare system like the US, that would not give you a better vaccine rollout.

Actually, it would and that's what happened in the US. We had the private facilities and the drug tech to make it happen and that's due in part to not having an entirely socialized medical system. Like it or not money incentivizes drug research. I don't know how you could claim that if Canada had the ability to mass produce the vaccine like the US did that they wouldn't be ahead in their rollout.

Canada had the extra step of trying to figure where they were going to get their vaccines and when since they didn't have the ability to create it in country. That's a massive disadvantage.

On the other hand, here in the UK - the socialized healthcare system is making it much easier to ensure doses get to people who need them. Something like 95% of over 50s have gotten their first dose. While I may not like it, the vaccine rollout is slowly going down the age ranges (40+ and vulnerable people are eligible now), and your doctor will let you know when you can book an appointment. I think that this helps ensure that there is less inequality in vaccine access.

The AZ vaccine was also researched in the UK, with lots of production here too. That especially surprising considering very little vaccine production happened here before COVID. What is probably hurting Canada is their small population, making researching and producing their own vaccine much more difficult.

>On the other hand, here in the UK - the socialized healthcare system is making it much easier to ensure doses get to people who need them. Something like 95% of over 50s have gotten their first dose. While I may not like it, the vaccine rollout is slowly going down the age ranges (40+ and vulnerable people are eligible now)

Vaccines are available for all Americans 16 and older. I'm not sure when this occurred nationwide, but California made vaccines avaiable to everyone 16 and older since April 15, and other states did so before then.

>The AZ vaccine was also researched in the UK, with lots of production here too. That especially surprising considering very little vaccine production happened here before COVID.

The UK invested a lot of money to build plants during the past year.

>What is probably hurting Canada is their small population, making researching and producing their own vaccine much more difficult.

Canada produces a lot of vaccines; just not the types appropriate to convert to COVID19 shots.

>Vaccines are available for all Americans 16 and older. I'm not sure when this occurred nationwide, but California made vaccines avaiable to everyone 16 and older since April 15, and other states did so before then.

Despite the vaccine not being available to many people in the UK (people aged 16-40) that a greater percentage of adults in the UK have received at least one dose. Some of that can be attributed to lower rates of vaccine hesitancy, but some of it is surely related to the NHS being better at outreach than the fragmented healthcare system in the US.

>Despite the vaccine not being available to many people in the UK (people aged 16-40) that a greater percentage of adults in the UK have received at least one dose.

Most countries have prioritizing giving one dose to as many as possible first and delaying the second dose, believing that doing so is preferable to prioritizing second doses when the goal is the most widespread (as opposed to optimal per person) immunity possible. The US hasn't had to do this because it bought enough vaccines last year for every American from each of the countries working on a vaccine, leading to the current luxury of being able to schedule second does at the recommended interval. The UK is in better shape than the EU or Canada but does not have as much as the US, leading to its strategy.

>Some of that can be attributed to lower rates of vaccine hesitancy

Vaccine hesitancy in the UK is unusually low, I agree, based on the YouGov data I've seen, but overall anti-vaccine sentiment is higher in Europe than in the US. https://www.forbes.com/sites/joshuacohen/2021/03/08/covid-19...

>but some of it is surely related to the NHS being better at outreach than the fragmented healthcare system in the US.

There is no evidence of this. In the US, it is impossible to go anywhere without hearing or seeing vaccine offers. In addition to government- and hospital-run mass vaccination sites, every chain pharmacy offers vaccination at every location including Walgreens. Meanwhile, Walgreens' UK affiliate Boots only offers vaccination at 17 locations (https://www.boots.com/health-pharmacy/covid-19-information-p...). Superdrug offers it at a handful of locations as well. (https://www.superdrug.com/corona-update/faq)

Perhaps you are right, I am just surprised with almost a month of unrestricted vaccine uptake opportunities in the US, the rate of vaccination (people who have taken at least one dose) is significantly lower than the UK, which as you note is experiencing significant supply difficulties. I also think that dealing with vaccine hesitancy effectively is the mark of a good healthcare system, but of course there can be many causes of vaccine hesitancy and there is no good way to measure outreach.

>I also think that dealing with vaccine hesitancy effectively is the mark of a good healthcare system, but of course there can be many causes of vaccine hesitancy and there is no good way to measure outreach.

The French health care system consistently rates as among the best in the world. France has the highest vaccine hesitancy among developed countries (https://www.theatlantic.com/international/archive/2021/03/fr...).

I think you're conflated 'socialized' with 'nationalized'. The vaccine research and deployment was motivated by profit, but the US government was the one of the only customers. The beneficiaries were the citizens, based on need rather than their available excess capital. That sounds unlike normal US 'capitalist' healthcare, and very much like socialized healthcare.

Yes but the reason the US has these massive drug manufacturers and leads in drug research is not due to socialized healthcare at all. It's purely profit driven.

The UK has a "socialist" healthcare system similar to Canada's yet its vaccine rollout is doing better the the US.

I don't think the problem is your "socialist" healthcare system.

>yet its vaccine rollout is doing better the the US.

The UK only has higher percentage with 1 vaccine dose. US has a higher percentage of people totally vaccinated.

https://www.nytimes.com/interactive/2021/world/covid-vaccina...

That does not contradict the parent. The UK has a better vaccine roll out strategy than the US since the figure of merit is not the number of people with two doses. The big gains are from the first dose so the UK has prioritized getting those into as many arms as possible. So, while the number of doses given per capita is almost exactly the same in the US and the UK, the UK has a significantly better level of protection. In addition the UK has very strongly prioritized the most vulnerable. The net result is that I expect the UK to have an entire day without Covid deaths within the next two weeks, something which would have been unimaginable during the peak in mid-January.

In more or less every other respect the UK government has done a terrible job of managing the pandemic but the vaccine rollout has been very well thought out and implemented.

Don’t feel bad. End to end, most US vaccination is “socialist” mass vaccination by the government.

No system is perfect. In the US, even if you buy our very expensive insurance, you might find yourself on the hook for tens of thousands of dollars in hospital bills.

You might get treated by an out-of-network surgeon without knowing about it, so your insurer passes the full cost on to you.

You might get picked up by a rescue chopper and have the insurance company later deem it "not medically necessary" and leave you with the bill.

You might have gall bladder surgery and after the fact have your insurer say they're not paying because it was "elective".

Two-thirds of bankruptcies in the US are tied to medical issues. Personally, I'd always considered the financial security Canada's healthcare system provides to be worth the drawbacks... but then again, I live in the US.

With America pumping out 4 million doses a day... Canada can be inoculated in a single week. Expect to see that gap crumble over the next two months and with lower vaccine hesitancy... Canada will likely cross the finish line before America.

<s>I'm extremely unimpressed with the vaccination rate in Canada. I feel like they really dropped the ball.</s> Edit: it was clarified upthread that the 3% number is misleading and Canada is actually doing much better than that number suggests.

> The trick was to fly because land crossing has been closed to non-essential traffic since March of 2020.

Is this right? It doesn't jive with my experience. I was able to cross the land border - both ways - around August.

Well, Canada doesn't prohibit you from leaving and when you come back, if you have Canadian citizenship, Canada won't block you from coming into your own country. What they are blocking is non-Canadians.

During the pandemic we kept hearing that collectivist cultures and socialized medicine would have the upper-hand. Yet Canada's vaccination rate is abysmal (32% vs 2.55% are completely covered with the required two doses [0]) when compared to the United States.

What's the explanation here?

[0] https://www.nytimes.com/interactive/2021/world/covid-vaccina...

>What's the explanation here?

Incentives matter?

Canada does not have any production facilities and has been unable to give vaccinations as a result. Our daily vaccinations per capita are nearing or exceeding the US at this time and we are accelerating as we receive more doses. 2nd doses have been delayed to ensure maximum efficiency of the supply we have.

The US government threw its weight around to ensure that it would have manufacturing capability and doses. If Canada physically had more doses, they'd have more shots in arms.

That is a good point at-least for western powers the more socialist the country the less "weight" it possesses.

That's smart. Pharma production is a strategic asset. Would be unthinkable to have the US aerospace industry outsourced to foreign countries for instance. Is there a different perception in Canada?

Trust the market has been repeated ad infinitum for decades. Except when the sh*t hits the fan the market either collapses or is nationalized. We saw this with PPE and we see this with vaccines. People are either going to have to pay more to maintain in-country manufacturing or just wring their hands and whine. Those who can manufacture have done well. Some export and some do not. Countries have learned who their friends really are or that there are no friends. Vaccine production has greatly increased but it’s going to be very hard to get dosing outside the g20.

Canada doesn’t have the ability to manufacture the vaccines. The United States does. The United Kingdom also has manufacturing capabilities and has had a strong vaccine rollout.

it's not like there is one manufacturer. the vaccine manufacturers contract out to a bunch of small contract chemists to get it done. Surprising that there aren't any at all in canada.

> Surprising that there aren't any at all in canada.

Countries like the US and UK have banned export of the vaccine, but also of the needed materials.

Not to mention, my perception (and maybe it's only that) is that socialized healthcare is being used as an extra excuse for putting restrictions on what we can do, because we are all dependent on the state and they can't take care of us adequately. I know there is more subtlety than that, but personally I only see that socialized healthcare can be compatible with free society when it is completely decoupled from telling people how to behave

> is being used as an extra excuse for putting restrictions on what we can do

How's the population dealing with these random arbitrary checkpoints and curfews? Are those popular measures?

Culturally we don't really stand up for ourselves, and my perception (as a tech worker) is that calling out any of these measures in my social group is roughly equivalent to saying I don't believe in vaccines or climate change or something, so I've not heard a lot of people voice strong contrarian views.

Also, these policies are much worse for the working class that we don't seem to care about, which are either immigrants or people outside of Toronto or Montreal, so don't count for politicians. It's just really another conversation piece for the zoom crowd.

Canadians feel many of the restrictions are justified in light of the pandemic. Once it ends, Canadians will stand up if the restrictions don't end.

If you are short on vaccines, first dose first is the obvious strategy, so you hsouldn't compare complete coverage.

Canada has had 3x fewer deaths per capita, so I would still say they are a success case compared to us.

US death numbers are not an outlier once you consider

1. The US population is on average over 30lb overweight compared to the rest of the world with significant comorbidities (In the United States, 36.5 percent of adults are obese. Another 32.5 percent of American adults are overweight. In all, more than two-thirds of adults in the United States are overweight or obese),

2. has very old population similar to Italy (though this is similar to Canada too)

3. has tons of tourism during winter

4. Canada has a population density of 4 people per square kilometer and population of 1/10th of US. This density is even bigger factor for COVID and crazy dense cities. US has a population density 36 per Km2. US also has the third-highest population in the world.

5. New York was been found to be the origin of virus variant for majority of the US states - something Governor Cuomo played a big role in. Plus back in March, the American Health Care Association told Cuomo, Wolf, Murphy, Whitmer etc to stop ordering infected patients into nursing homes. The governors ignored the AHCA and removed their own family from nursing homes while forcing others:

https://www.ahcancal.org/News/news_releases/Pages/Long-term-...

https://www.nbcnews.com/news/amp/ncna1191811

US numbers could have been better if it didn't have such major obesity problems.

> 1. The US population is on average over 30lb overweight

Not far off from Canadian numbers, you can look it up. Canada is at pretty much exactly 2/3 overweight + obese. Certainly not 3x as high.

> 2. has very old population similar to Italy (though this is similar to Canada too)

As you noted, also similar to Canada.

> 3. has tons of tourism during winter

Is winter tourism worth an additional 400k deaths when you scale out the per capita difference?

> 4. Canada has a population density of 4 people per square kilometer

This is just a bad argument, for the obvious reason that dividing the Canadian population by the entire area of their landmass tell you nothing about the density of their cities or how many people live there. China has first-highest population in the world, way fewer people died there.

SF is one of the densest cities in the US and it had a low covid death rate.

> 5. New York was been found to be the origin of virus variant for majority of the US states - something Governor Cuomo played a big role in

The NY variant doesn't spread more easily, unlike other variants. Granted, Cuomo is an idiot (I've been an early adopter on that line of thought, he basically got famous early in the pandemic for how much of a failure his state was but people didn't realize it), but I don't think you can pin the entire discrepancy on Cuomo.

As far as I can tell, we actually have no way of knowing that the NY variant doesn't spread more easily than other variants. There just isn't the data to disentangle whether that variant became more widespread because everyone did a worse job of stopping that particular set of cases from spreading, or if everyone was less successful because the variant in question was worse. We'll probably never have a definite answer.

>(I've been an early adopter on that line of thought, he basically got famous early in the pandemic for how much of a failure his state was but people didn't realize it)

It's hilarious to look back in retrospect at how inflated Cuomo and DeBlasio's egos got in the early days of the crisis when NYC was one of the world's epicenters. They clearly both believed that appearing on national television in their "daily briefings" would lead them to greater things, perhaps the White House. (Same happened with Newsom in California.) Welp.

Newsom actually got a lot less coverage on national television, which is hilarious because California's response was objectively better than NY & NYC.

Meanwhile, NY goes up in flames and suddenly Cuomo is on TV every day and his approval rating was skyrocketing.

>Meanwhile, NY goes up in flames and suddenly Cuomo is on TV every day and his approval rating was skyrocketing.

Because he was for several months the most prominent exponent of Orange Man Bad. *He even won an Emmy!* https://www.ocregister.com/2021/02/17/an-emmy-for-cuomo-migh...

1. My comment stated "36.5 percent of adults are obese. Another 32.5 percent of American adults are overweight".

Among men, the prevalence of obesity was over 8 percentage points lower in Canada than in the United States (24.3% compared with 32.6%) and among women, more than 12 percentage points lower (23.9% compared with 36.2%):

https://www.cdc.gov/nchs/products/databriefs/db56.htm

12 and 8 percentages are fairly higher in comparison - especially when we are talking about percentages. USA which has 9-10x the population of Canada, 12% makes a very big difference.

3. You are severely underestimating the tourism. Yes, tourism in USA in winter is very high. Canada tourism in winter is significantly lower due to extreme cold weather. Almost all the trips for cruise ships, water parks (Disney), famous cities, national parks etc happen in USA. The snow season in Canada prevents all those.

https://www150.statcan.gc.ca/n1/daily-quotidien/200221/dq200...

> The number of tourists from overseas countries (countries other than the United States) rose to 7.1 million arrivals (+454,000) in 2019, while the number of US tourists to Canada rose to 15.0 million (+554,000). The summer months—June through September—were the peak months for tourism arrivals from overseas to Canada, representing 51.9% of all arrivals from overseas during 2019. By comparison, the peak months for tourism arrivals from the United States were May to October, with 68.8% of all US tourist arrivals to Canada.

> Canadian residents returned from 4.8 million trips abroad in December, up 2.9% from the previous month. Of these 4.8 million trips, 3.8 million were to the United States, up 3.3% from November. Almost three-quarters of these trips to the United States were made by car. Same-day car trips across the border edged up 0.4% to 1.8 million in December, while the number of return trips from overnight car trips rose 9.4% to 966,000. The number of plane trips to the United States rose 1.5% since November to 877,000. This was 4.7% higher than in December of the previous year. In December, travel to overseas countries by Canadian residents rose 1.8% to 1.1 million trips—the highest level on record for the month of December.

Now lets look at the opposite for tourism to USA:

> In 2019, the number of international tourist arrivals to the U.S. stood at almost 80 million after being on the rise for over a decade. 47.88 of that came from Americas (Canada being the first followed by Mexico).

https://www.statista.com/topics/1987/travel-and-tourism-indu...

https://www.statista.com/statistics/1012283/united-states-in...

> In 2019, there were approximately 20.72 million overseas visitors from Canada to the United States. The visitation figures from Canada peaked in 2013 when the U.S. received a total of 23.41 Canadian citizens across its borders. In 2019, Canada placed first in terms of the most visitors from one nation to the United States, followed closely by fellow U.S. neighbor, Mexico.

https://www.statista.com/statistics/214764/number-of-visitor...

A large number of Canadians in the Niagara region also cross the border for simple stuff like cheaper goods. Nobody does the opposite.

Also international travellers from Canada often fly through US but not vice versa. When I have to visit my home in South Asia, it's always cheaper for me to fly through US. This is not true for the opposite.

And even the ones who visit places in Canada like Toronto and Niagara Falls visit New York too. And a lot of tourists come from Canada who visit places in south like Florida. Anecdotal - I know 3 families here with whose retired members all spend their winters in Florida and another family which spends it in Austin Texas.

4. Like I said, you sliced my point in half and ignored the rest of my comment where I state "This density is even bigger factor for COVID and crazy dense cities." Look at the population density of the 10 highest dense municipalities in Canada (highest is 5,492.6 people per square kilometre in Vancouver, B.C.):

https://www150.statcan.gc.ca/n1/daily-quotidien/170208/t001a...

Now compare it to USA. Top 50 cities amongst them all are signifiantly higher than the Canadian numbers. New York City alone is 10,431.1 people per square kilometre, San Francisco is 6,658.9, Boston is 5,143.4):

https://en.wikipedia.org/wiki/List_of_United_States_cities_b...

5. False. From NYTimes: "Travel From New York City Seeded Wave of U.S. Outbreaks: The coronavirus outbreak in New York City became the primary source of infections around the United States. That helped to fuel outbreaks in Louisiana, Texas, Arizona and as far away as the West Coast. The findings are drawn from geneticists’ tracking signature mutations of the virus, travel histories of infected people and models of the outbreak by infectious disease experts":

https://archive.is/fEPG7

>During the pandemic we kept hearing that collectivist cultures and socialized medicine would have the upper-hand.

You would think that the contrary would be true. If your health system is overloaded, it being socialized cannot make it better at first glance. Access isn't the issue, availability is (and this is what is seen in Canada right now).

Although I agree collectivist cultures probably have the upper-hand (e.g. China was able to enforce pretty stringent measures and pool resources to build hospitals).

A few months ago, the Canadian government chose to prioritize first doses first. I know the BC government changed their vaccination schedule after this announcement such that everyone should be able to get their first dose by June or July. https://news.ycombinator.com/item?id=26360556

At least everyone is equally unvaccinated.

The previous government scrapped and shutdown all domestic vaccine manufacturing. Hard to get it all up and running again on short notice.

Also, we stopped giving out second doses to prioritize first doses. So that stat will definitely look horrible. But... we're still very low on first doses, only about 33%. :(

Hasn't it been half a decade already?

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