Ontario's COVID-19 vaccine rollout has reached a crucial moment, with more supply arriving every week and the province saying it's on track to administer at least one dose to 65 per cent of adults by the end of May.
But three weeks after Ontario's top doctor said the province could administer "well over" 500,000 vaccinations per day with ample supply, the province is nowhere near that level.
Health officials say the daily average in recent weeks is 97,200, while the daily record is 136,695 shots.
So, what is the best Ontario could do if vaccine supply wasn't an issue? CBC Toronto reached out to all 34 public health units, which are leading local rollouts, and Ontario's pharmacy association to find out.
Our findings indicate the actual top-line number appears to be closer to approximately 373,000 doses per day — though that remains an estimate due to inconsistent data from some public health units.
CBC Toronto's figure doesn't include vaccine data from primary care centres. Additionally, seven public health units didn't provide any data. In some instances, including in Toronto, Peel and Ottawa, the numbers for daily vaccine delivery capacity administered in pharmacies are counted twice.
Dr. Barry Pakes, program director in public health and preventative medicine with the University of Toronto's Dalla Lana School of Public Health, said 500,000 doses a day isn't unrealistic with the right resources and infrastructure — but that's not in place right now.
"If all the vaccines arrived today [could we do] 500,000 a day? No, absolutely not," he said. "Could we increase by about 50 per cent our capacity in these mass vaccination clinics? I absolutely think we could."
Experts have been clear that Ontario can't vaccinate its way out of the devastating third wave of COVID-19, which has brought the province's health system to a breaking point. However, the success of the immunization drive will make a huge difference when it comes to relaxing public health restrictions (a province-wide stay-at-home order remains in place) and possibly preventing a fourth wave of infections.
Canada's largest province is expecting more than four million vaccine doses by the end of May — so it will soon have a chance to ramp up its efforts.
The latest figures show 43 per cent of Ontario's adult population have received at least one shot.
Public Health Ontario released data this week showing the power of vaccines. So far, just 2,223 people who were partially or fully immunized were infected and developed COVID-19. More than 5.5 million doses have been administered in Ontario.
Vaccine rollout differs depending on where you live
Local public health units continue to lead vaccination efforts.
Toronto, for example, can deliver approximately 57,000 vaccines per day, according to Dr. Isaac Bogoch, a member of Ontario's vaccine distribution task force. That number factors in mass immunization and hospital-run clinics, as well as mobile and pop-up sites, and shots being delivered at pharmacies and primary care doctors' offices.
In neighbouring Peel Region, which, like Toronto, has a large number of provincially designated COVID-19 hot spots, that capacity is approximately 32,000, Bogoch said. A spokesperson for Peel Public Health, however, told CBC Toronto that number is closer to 16,500.
Elsewhere it's lower. Most public health units can do between 1,100 and upward of 10,000 vaccinations per day. Seven health units didn't say how many they could do if supply wasn't an issue.
Bogoch said he finds it difficult to comment on the 500,000 figure mentioned by Williams because he isn't sure where that number came from.
CBC Toronto has asked Ontario's Ministry of Health for clarity on that number several times but hasn't been given an answer.
The more realistic and attainable target for Ontario is 150,000 vaccines per day, Bogoch said.
"If we're around 150,000 per day, we're doing something right," he said. "That's basically equivalent to when the United States was vaccinating at a very fast pace."
What needs to change to increase vaccination rate?
Bogoch said several factors must work in tandem for Ontario to get more shots in arms, including: having ample vaccine supply, getting multiple vaccination sites operating at once and using more people to administer shots.
Pakes, who has done that work in the GTA, said a more user-friendly booking system, better communication from the province and a more streamlined, centralized approach would also help.
"We don't have, and have never had a health system, that actually connects hospitals, primary care, specialty care, labs, pharmacies," he said. "That's a barrier that we're not going to be able to get over during this pandemic, but is absolutely something we need to think about."
Bogoch said one key to achieving 150,000 daily doses is allowing more pharmacies and primary care providers to offer COVID-19 vaccines.
Currently about 30 per cent of Ontario pharmacies have been able to administer vaccines, and the province is working to expand on this.
"The sustainable long-term goal is vaccinating through primary care and through pharmacies," Bogoch said. "We obviously need to really focus on expanding their role throughout the province."
The province has said primary care doctors, who contact eligible patients for vaccines, are important in the vaccine rollout, but it hasn't released any information about expanding their role.
The Ministry of Health didn't answer questions on this topic.
Hotspot popups need more staff, hours
Both Bogoch and Pakes say there still needs to be a focus on vaccinating people in hot spot areas.
The CEO of Flemingdon Health Centre helped run the province's largest hotspot pop-up clinic last month in Thorncliffe Park, a neighbourhood in eastern Toronto, which saw 3,000 people get their first dose.
"That took dozens of community health ambassadors, dozens of clinicians and dozens of administrators, as well as a large physical space to be able to be delivered in about nine hours," Jen Quinlan said.
In order for pop-up clinics to increase vaccination rates more space, time and staff are needed, she said. In some instances, staff that would be working at pop-ups are instead helping in hospitals, where the situation is dire, Quinlan added.
Quinlan also suggests allowing more health-care providers to administer vaccines. She points to one community health centre that's training a handful of chiropodists (foot specialists) to deliver injections.
She also said it would help if more employers held clinics so essential workers can access vaccines on paid work time.
There are nine employer-led clinics running in Toronto and Peel this month.
Both Quinlan and Pakes say soon Ontario will hit a ceiling — everyone who is eager to get vaccinated will be booked before the focus turns to addressing hesitancy and people who fell through the cracks.
"Then it'll be really up to us as community leaders and community organizers to make sure that those who are struggling to get access, as well as to have the appropriate information on what's safe and how to access, can really be targeted," Quinlan said.
ABOUT THE AUTHOR
Angelina King is a reporter with CBC Toronto where she covers a wide range of stories. She has a particular interest in crime, legal and justice issues and human interest stories. She previously reported on national and international news. Angelina got her start in her home city of Saskatoon where she spent much of her time covering the courts. You can contact her at firstname.lastname@example.org or @angelinaaking
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