Data driven decisions need complete data

Each Monday morning at 7:40am I am on the Political Panel hosted by Stephen Quinn on CBC Vancouver. We discuss (and debate) the current events.

This week the COVID-19 vaccine roll-out plan was the topic of discussion. According to government the plan is data-informed, the main point of contention debated on the panel was the data the government is using to design the plan is incomplete. Without more detailed disaggregated data about how the pandemic is impacting certain communities differently, in particular race-based data, we may be missing key markers for how we can better target our response. My colleague Sonia Furstenau wrote about this in Daily Hive and asked Minister Adrian Dix about this issue in December and he just brushed her off. Others have also criticized the province’s data challenges.

Late last week the provincial government updated British Columbians on the vaccination plan. After high-risk populations – long-term care residents/staff, COVID-serving health care workers, remote Indigenous communities, seniors over 80, Indigenous elders over 65, other health care workers and group home settings –  vaccines will be allocated based on 5-year age groups (79-75, 74-70, 69-65, 64-60…), in addition to those who are “clinically extremely vulnerable.”

The objective of this approach is to limit fatalities above all else. This is, of course, a defensible approach as COVID-19 mortality is most strongly associated with age. Earlier plans from the province, however, proposed a hybrid approach that would have also included essential and frontline workers to limit transmission.

British Columbia’s vaccine rollout plan, at this point, does not include priority access for at-risk workers, such as teachers and workers in food processing facilities. While those employees may be younger and less likely to die from the virus, we should not ignore the harm caused by infection, especially with critical questions yet to be answered about possible long-term health impacts.

While it is important to protect our elders, I am grateful evidence-based allowances have been made to give prompt access to key health care providers and remote Indigenous communities. I worry, however, that we are missing out on other key groups in need of priority protection because our data is lacking. It is frustrating that the province did not start collecting disaggregated data about COVID-19 infections last Spring.

Data-informed decisions are always better with more data than less. So, if the province is committed to making decisions about who to vaccinate and when, disaggregated data would allow us to make even more targeted decisions to protect those most at risk. For example, we know Indigenous people are more at risk of serious infection, but what about other communities? We should have race-based data. It is possible that Black British Columbians are also at elevated risk.

Data in the United States shows “the average age of death from Covid for a white person is 81, but for a Latinx person it’s 67, and for a Black person it’s 72.” If you proceed with a purely age-based allocation in that context you risk compounding harms to certain demographics. I am hopeful Canada’s public health care system is minimizing those disparities somewhat, but I’m not confident we’ve eliminated them. If we had the information specific to British Columbia then we would be able to make more informed decisions. In fact, the provincial government has shown a willingness to respond to data by making concessions in their plan for vaccinating Indigenous elders 65+ at the same time as the 80+ demographic.

It is precisely because we collect health data about Indigenous people that we can make more precise decisions about the vaccination plan. So, what are we missing? Who are we missing? We should not ignore the disparate impacts of this epidemic but unfortunately, we may never know because the BC NDP government has stubbornly decided to not collect the data.

Image by Triggermouse from Pixabay