October 18, 2021

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Fraser Health becomes “flexible, agile and adaptable” to cool COVID-19 hot spots


New data sheds light on why Surrey has had some of the highest COVID-19 case counts in B.C. It may also provide a path forward.

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Data released this week by the B.C. Centre for Disease Control may provide some insight into the reasons Surrey has been the “epicentre” of COVID-19 in B.C. for much of the pandemic.

“Within B.C., Fraser Health has been the centre (of the pandemic) since after the first wave,” Fraser Health CEO Dr. Victoria Lee told Postmedia on Friday. “Within Fraser Health, Surrey has been the epicentre.”

B.C. CDC data shows that several Surrey neighbourhoods in particular have borne a “disproportionate burden of the pandemic,” including West Newton, which recorded an average of 60 daily cases per 100,000 people between May 4 and 10 — more than anywhere else in B.C.

In comparison, Whalley had 50 daily cases and East Newton had 49 daily cases, while Vancouver’s Hastings-Sunrise neighbourhood had 17.7, Kitsilano had 7.1, Burnaby Southwest had 15.3 and Downtown Kelowna had 13.3.

The higher transmission in some Surrey neighbourhoods may reflect risk factors in those places that aren’t as prevalent in others, said Lee.

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For example, some parts of Surrey are high-density, which is linked to higher transmission rates in general. Socioeconomic factors may also play a role, as well as the type of work people do, such as working in food processing or essential services. Living arrangements, such as living in a multi-generational household, can also contribute to higher case numbers.

Neighbourhood statistics collected during the 2016 census show that Newton, including both West Newton and East Newton, displays several of those risk factors. It is one of Surrey’s highest-density neighbourhoods. The average household income in Newton is lower than the rest of Surrey ($90,049 compared to $93,586), with a slightly higher proportion of renters and a slightly lower labour force participation rate.

Forty-nine per cent of Newton’s population are immigrants, compared to 43 per cent for Surrey as a whole. Fifty-eight per cent of the population is of South Asian descent, while 39 per cent of the population is between the ages of 35 and 64.

Multi-generational households, in particular, have been hard hit by COVID-19 variants that are more contagious, said Lee.

During the first and second wave, a sick person who isolated at home would not necessarily pass on the virus to other members of their family, but as variants have become more prevalent, it has proven “nearly impossible” for people living together not to get sick.

Lee noted there are pockets of Surrey that are predominantly Caucasian as well.

Newton, which was once known as a rough town criss-crossed by railway tracks and King George Boulevard, has undergone rapid change and growth over the last three decades. Many had pinned hopes for revitalization of the urban centre on the Light Rail Transit (LRT) project before it was scrapped by the city in favour of SkyTrain.

Lee said a multi-faceted approach has emerged as the best way to reach as many people as possible in B.C.’s most diverse neighbourhoods.

Fraser Health has been working with community leaders to understand barriers to accessing health information and getting vaccinated and then developing ways to eliminate them, she said.

As a result, several unique initiatives have emerged in tandem with the municipality and community groups, including providing supports to families that have to isolate, including food, as well as transportation to testing sites.

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Lee said it has also proved important to “meet people where they’re at” to help them register and book vaccination appointments. In a religious neighbourhood that has meant holding targeted registration events at gurdwaras, mosques and temples, which are then followed up by an immunization clinic for those who registered the week before.

In addition to “on the ground” work, Fraser Health has gone online to hold town hall meetings in different languages or with young social media influencers.

B.C.’s largest health authority has had to be “flexible, agile and adaptable,” said Lee, who chose to work in Fraser Health in part because it is a “global village in a local setting.”

As of Thursday, 800,080 people had been vaccinated across Fraser Health.

People receive a COVID-19 vaccination from nurses at the Dukh Nivaran Sahib Gurdwara in Surrey on May 7, 2021. The pre-booked appointment-only Fraser Health event administered about 400 Pfizer shots. More events are planned for other high transmission neighbourhoods.
People receive a COVID-19 vaccination from nurses at the Dukh Nivaran Sahib Gurdwara in Surrey on May 7, 2021. The pre-booked appointment-only Fraser Health event administered about 400 Pfizer shots. More events are planned for other high transmission neighbourhoods. Photo by Jason Payne /PNG

On Thursday, provincial health officer Dr. Bonnie Henry was asked about the possibility of increasing immunization events at gurdwaras and temples rather than holding them in other places.

“We need to do all of these things,” she said. “Not one or the other.”

Henry said the focus is on getting people to register and supporting them to get to a mass clinic, but that could change if new research on the stability of the Pfizer vaccine shows that it can be kept thawed for much longer than previously thought.

“Health Canada’s in the process of reviewing (it),” said Henry, adding “that (would) make it much more flexible for us to be able to … not only register people, but bring vaccine to temples, to gurdwaras, to other community places where people are more comfortable.”

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Health Minister Adrian Dix thanked community groups and leaders for their support in the vaccination campaign.

“By local health area, Surrey is more vaccinated than average, but when you look at different neighbourhoods in Surrey, the level of immunization varies,” he said. “But there has been an enormous effort and that effort is going to continue to grow.”

Dr. Heidi Tworek, professor of history and public policy at the University of B.C., said that what is sometimes labelled or viewed as vaccine hesitancy is actually a lack of access.

“We lump together confusion about how to register for the vaccine or lack of access and call it hesitancy,” said the expert in health communication. “It’s a more complex problem, and when we call it hesitancy, we miss this piece about access, which we can actually do something about.”

Tworek said B.C.’s rollout may have confused some people who don’t understand the difference between registering for a vaccine and booking a shot, but she applauded the government’s website, which is easy to use and provides services in many different languages.

She suggested that B.C. could “flood the zone” by sending a letter explaining the vaccination process to every household.

“It may be redundant for some people who have already registered, but it may reach others who haven’t,” she said.

Using the emergency text alert system is another option, or distributing posters and leaflets.

“There’s evidence that these kinds of nudges can be incredibly effective,” Tworek said. “Of course there will be duplication, but the goal is to reach as many people as possible.”

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Involving civil society, such as religious or community leaders or celebrities, can also be helpful.

“I think the push needs to be in getting people to register,” said Pary Dulai, one of the organizers of Surrey’s annual Vaisakhi parade, which in a non-COVID year would have drawn more than 500,000 people to Newton.

Rather than using a website, Fraser Health should use existing infrastructure, such as pharmacies, markets and gurdwaras, to help people register, he said.

gluymes@postmedia.com

twitter.com/glendaluymes


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