President's COVID-19 Forum

Answered by Kelly Grindrod

Based on antibody studies right now, we might want a booster around six months. However, we are still looking at types of immunities (such as t-cell immunity) that may dictate if this is actually needed. Like Israel and France, we may see a third dose offered to people who have a poor immune system (transplant or cancer patients), or in older populations. When looking at a case where someone fully vaccinated ends up in the ICU, often they fall under one of these categories. Especially in the context of global vaccine scarcity, we may not see third dose for the majority of the population in the next six months.

Answered by Kelly Grindrod and Zahid Butt

The most topical one in Canada right now is not mixing in fact, but the interchangeability of mRNA vaccines; it’s same kind of vaccine, just two different brands. With AstraZeneca (a viral vector vaccine), people had the option to follow up with a second viral vector vaccine or an mRNA.

In the US, this question is starting to come up now, because there may require an mRNA booster required for the Johnson & Johnson single dose (viral vector) vaccine. They’ve found it may not cover as well as we need for current or future variants. We went through this in Canada a bit earlier with AstraZeneca (also a viral vector vaccine); people had the option to follow it up with a second viral vector so they don't mix or to follow it up with an mRNA vaccine where they do mix.

AstraZeneca was meant to be the world's vaccine. It was inexpensive and easy to transport. Unfortunately, it had the side effect, the vaccine induced blood clots. That's similar to Sputnik, Russia’s vaccine (also viral vector). The Chinese vaccines, Sinopharm, for example, are inactivated vaccines and activated virus vaccines. These are like the more typical or traditional flu shot vaccines and are actually not as effective as the viral vector or the mRNA vaccines (from what we can see in the trials). If someone has had, for example, the Sinopharm vaccine, should we also offer a booster when they come to Canada? Or should Canada be recognizing someone as sufficiently vaccinated if they had, for example, two inactivated virus vaccines? These are questions that aren't fully answered yet. It's not just WHO recognizing vaccines, it's the country of Canada also recognizing these vaccines.

We might need to give people a booster that are entering from these countries without approved vaccines (because you have used a better or more efficacious vaccine while entering to Canada). Otherwise, it's going to be the same as unvaccinated people who have to quarantine.

Answered by Kelly Grindrod

Myocarditis is inflammation of the heart. It can also show up as something called Pericarditis, which is inflammation around the heart. And this was a side effect that showed up when we started vaccinating younger people, such as younger men in the Israeli and U.S. military. This is a side effect largely, not entirely, but largely affects teen boys and young men up to age of 26. Symptoms usually include chest pain and shortness of breath. It is worth noting that myocarditis also happens with COVID, and with flu viruses, when you have an immune response which can lead to this inflammation. In most cases we have no idea it's happening. It's not reported or assessed. It’s very fast to diagnose with an ECG, and is treated with over-the-counter pain relievers (such as ibuprophen). It is mild and can be treated at home. So this is something we're familiar with.

This is not the same as the blood clot side effect with AstraZeneca. This was new to us, and we had to learn very quickly.  We've seen a number of groups, weighing the risks and the benefits. Keeping in mind COVID also has complications, the conclusion of these analyses has been the benefit of vaccination still very heavily outweighs the risk of the vaccine.

The other topical side effects are around pregnancy and fertility. That misinformation, (when people intentionally share the wrong information), has been a big barrier. The same question has come up with many vaccines in the past. Repeatedly we've shown that these vaccines do not impact fertility. There's no evidence for this.

On pregnancy: there were people who actually got pregnant in the clinical trials. They're not supposed to but they did, and they've had good outcomes with those pregnancies. And a number of health care workers early on did choose to get the vaccine and there's been a lot of tracking of their pregnancies. There's no evidence that there's any change in outcomes (such as miscarriages). In comparison, COVID can be quite dangerous in pregnancy. For people who are still on the fence about this, these are great conversations to have with a doctor or a pharmacist.

Answered by John Hirdes

If we look at what's been reported about health service utilization in general: at the start of the pandemic (March to July, 2020) we saw a huge drop off in use of health services. Reduced emergency department visits, surgeries, and primary care visits. I've just done some analysis that says the same thing happened in terms of psychiatric hospitalizations. The psychiatric drop was elective in the sense it was mainly people with depressive symptoms that were less likely to come in for those services. The question is, "Did they get picked up elsewhere?" Well, the drop-off in primary care visits probably meant that they weren't seeing family doctors. As a whole, we haven’t done as well as we could in picking up the virtual health services.

As part of the president's advisory committee on student mental health recommendations, we put in place new, virtual mental health services prior to the pandemic. We did see the drop-off in-person counseling services, but there was some pick up of that virtually. I think there's tremendous potential in in virtual visits, and I think it's a technology that will continue to develop after the pandemic. It may turn out to be one of the benefits of having that kind of clinical service delivery become a normal part of services and a way to increase access to mental health supports.

Answered by Zahid Butt

Globally, this has been a supply issue first and an efficacy issue second. In a lot of countries, we are seeing a “pandemic of the unvaccinated,” which means that either you don't have the vaccine, or you have one dose and are awaiting the second. In the US, we are seeing a surge in the number of cases because so many people are unvaccinated.

It is still to be determined whether, for vaccines that are not recognized by WHO, a booster dose will be required; or, whether a full schedule of the vaccines is required in order to achieve the same level of immunity.

Answered by Kelly Grindrod

Originally, we expected that we could have vaccinations by September/October for children ages five to 11. Trials are ongoing right now in ages 11 and under, including down to six months old; however, given the risk of myocarditis that emerged in those aged 12 - 16 (especially in men and teen boys), Pfizer and Moderna have gone back to seek permissions and to notify the regulators that they will be running larger trials. The results for these larger trials could possibly delay the vaccination for the 11 and under group until later in the fall. This is all the more reason why we should double down on getting the 12 and older group vaccinated.

You want to try and get the entire household as protected as possible, especially around those who cannot be vaccinated yet. We see from other studies that children can transmit the virus (especially the delta variant) throughout the entire household.  

Answered by Zahid Butt

Beyond vaccines, some of the key initiatives needed to prevent a fourth wave are asymptomatic testing in at-risk neighborhoods, workplaces and schools, improved contact tracing and testing, and clear travel restrictions (such as a vaccine requirement) for those entering Canada.

PRESIDENT VIVEK GOEL: Hello everyone, thank you for joining the forum today. Before we begin it is important to reflect and acknowledge that the University of Waterloo is situated on the Haldeman Tract, land six miles on each side of the Grand River, granted to the Haudenosaunee of Six Nations by the Haldeman Treaty of 1784. The land inside and surrounding the Haldeman Tract, including our Stratford campus, is the traditional territory of the Attawandaron, Anishinaabeg and Haudenosaunee. I also acknowledge and recognize this area is now home to many diverse First Nations Inuit and Metis people

I'm excited to be here today and for the opportunity to speak to the University community for the first time in a real-time setting. I'm here live at Federation Hall and I'm joined here by several of my colleagues to discuss our return to campus life. I would like to thank everyone for the kind welcome I've received at the University and in this community. I look forward to continuing to meet with people and visiting across all four campuses. This is a new format for what used to be known as the President's Town Hall and one of the new things that we're trying out is the engagement of academic colleagues. In the future I hope to do other sessions on topics of interest to the community. Today, we stay focused on the issue that has been consuming us all - the pandemic. We are in a hopeful time as vaccinations progress but we also need to maintain vigilance and much work remains to be done. We will begin the event with a round table discussion with three University of Waterloo experts who can weigh in on some of the key factors that will affect and guide our return to campus this fall. This will be followed by an update on campus operations for members of the senior administration team. We will wrap up each part with a question and answer period. If you'd like to submit a question, whether it's for the experts or about campus operations, you can do so using the Q and A feature on the right hand side of your screen. The Q and A will be open throughout the event and I'll direct general pandemic questions to our experts during the round table. Questions about campus operations will be addressed during the Q and A period at the end. We know we can't address all of the questions today. The team is keeping track of the questions and we will endeavour to address them in other settings. I'm very pleased to welcome our panelists today Kelly Grindrod, associate professor in the School of Pharmacy. Kelly, thank you for being here.

KELLY GRINDROD: Thank you.

PRESIDENT VIVEK GOEL: John Hirdes, professor in the School of Public Health Sciences. John, welcome.

JOHN HIRDES: Thanks.

PRESIDENT VIVEK GOEL: And Zahid Butt, assistant professor in the School of Public Health Sciences. Zahid, thanks for being here.

ZAHID BUTT: Thank you.

PRESIDENT VIVEK GOEL: Thank you all three for joining us and sharing your time with the community. I just want to start with a few general questions and the first will be for Zahid. If you could give us your perspective on where we're at as a region as a province and country and what you forecast coming for the fall.

ZAHID BUTT: Sure. So the good and the positive point here is that when you're looking at Ontario, you're seeing a reduced number of cases so we are actually below the 200 mark for quite some time now. And you're seeing that decline in the number of cases. You're not really seeing a lot, many, hospitalizations and looking at the trend, if we are able to maintain that momentum with with our vaccination, we are going to see really a nice decline in cases and if there are any surge in cases where the health system would be able to actually, you know, control or, you know, could manage the cases but I think the main thing here is that, you know, vaccination is the key here you know especially your second dose vaccination or the full vaccination status that could take us, you know, easily into September so you're not able to see that that big wave that we saw last year.

PRESIDENT VIVEK GOEL: Thanks. So building on the importance of vaccination maybe Kelly you could tell us a little bit about where we're at with the vaccination efforts and particularly how we're going to continue to get to the levels of coverage we'd like to see.

KELLY GRINDROD: So right now we've got pretty good coverage for first doses we're getting over 80%. We're seeing those second doses numbers come up as well. We're getting a lot of the second doses are on a great trajectory. A lot of our clinics are still vaccinating a lot of people right now. The question is really around the next 10%. So how are we going to get from 80 percent to, really what we're probably aiming for is, close to 90 percent especially with variants coming out. It's going to be even more important to have really good coverage. Another group that we're struggling a bit with is younger adults. So, people in their 20s have been a bit reluctant to come in or maybe there's less importance for them or less of their friends have been getting it. You know, there's lots of reasons and so that's a group that we're focused on. Another group that we're really focused on is making sure that youth, so 12 and older, are fully vaccinated. So, pretty much today, actually, is the last day that you could get a first dose, and a second dose, and two weeks, and be fully vaccinated in time for school to start. So, there's a big push this week to make sure that we get as many youth as we can as soon as possible to get that coverage when school starts.

PRESIDENT VIVEK GOEL: Yeah, and what do you think will be some of the strategies to get to the most hard to reach populations that will most likely work?

KELLY GRINDROD: Yeah. This is the hardest group in that everybody else, for the most part, up until now, I mean, we were too slow for them. They couldn't wait to come in and get the vaccine. They were lined up. They were queuing for appointments. We've just switched to walk-in first dose and second dose walk-ins and we are seeing people use that often to move up their second dose a bit earlier, which is fantastic. It's exactly what we want to see. This next ten percent though, the challenge is they may be somewhat disconnected. Language may be a barrier. Education may be a barrier. A lot of fears around things like, and I'm hearing this directly when I vaccinate, worry about side effects you know. "I can't afford to take time off work, so if I have side effects, what am I going to do? Am I going to have to work through that?" So, trying to clarify with people that, you know the majority of people have very mild side effects is key, but also working with employers to bring the vaccines directly to the place of work - and we do have success with that. With certain populations, where they may not have good confidence in the vaccine, it's a matter of going with a mobile team. Maybe the first time you go you don't get a lot of uptake, but you go back, and then you go back again, and you go back again, and this is a lot of work so we're working as hard to get one dose out now then we may have worked to get a hundred or a thousand doses out when people really wanted it, but this is a critical gap to close, especially in areas that have lower vaccine uptake, which will impact specific schools, specific workplaces specific neighbourhoods. So we really want to make sure that everybody has that chance to get the information they need to get vaccinated.

PRESIDENT VIVEK GOEL: Thanks Kelly. So, we spend a lot of time talking about COVID and as a disease and its impacts, but we also know that been many other impacts on society and on individuals of both the disease and and the effects of the lockdowns and other measures that we've taken. So John, can you talk a little bit about what you've seen through your research and your experience and what measures we can take to support people as they return?

JOHN HIRDES: Yeah. So, I've been interested in trying to understand the mental health consequences of the COVID pandemic and I think one of the first things to maybe emphasize is that the the size and the the scope and the duration of the the COVID pandemic has been so substantial that this is probably a generation defining event. You know, as somebody who does research in aging, I often have talked about my grandparents generation who lived through the great depression and the wars and how that changed their behaviour over the course of their lives. I think we'll look back and the experience with the COVID pandemic will do that for all of us. It's affected everybody around the world. There are other subgroups that have been affected more substantially but all of us have been touched in one way or another. And the mental health consequences are complicated. In early research that I did, I found that the rates of depression and anxiety symptoms were about triple to quadruple in the general population compared to rates prior to the pandemic. But then, we've also, surprisingly, seen a drop in suicide rates during the the pandemic and that may be because there was some social cohesion that brought folks together. There's some concern about a lagged effect as we sort of come out of the pandemic. We always have to be careful about the recovery phase from serious mental health concerns. People have had a substantial impact on the economic side of things about how that's affected their lives and the well-being and then we also have to think about the the people whose family members have been affected by it. So, some recent work that I've done suggests that there's about 2.4 million Canadians who've had a family member or friend or co-worker die due to COVID and so if you think about the impact of that, the size of that impact, about a third of Canadians know somebody who's been directly affected by COVID, that's close to them. And so, there'll be some long-term effects that we have to sort out of that and then as we hopefully come out of the pandemic, we shouldn't assume that life will just return to normal magically. There'll be a need for supports for people to reintegrate and get used to being in group settings again and deal with with some of the lingering concerns that we've had being socially isolated during the pandemic.

PRESIDENT VIVEK GOEL: So, can you say a few words about, for our own community as as we're returning to campus, what should people be thinking about in terms of supporting students or colleagues that have had some of these effects?

JOHN HIRDES: Well one of the things that may have been very successful during the pandemic is the sense of community cohesion and people reaching out and being aware of the needs of those around them. So I think the first thing we should all do is take personal responsibility for watching out for each other, listening if there's somebody that's struggling, reaching out to them to offer supports. If you are experiencing mental health concerns, then talk about it with friends and family members. One of the great things that's happened in the last decade is that we've become more accepting as a society about talking about mental health issues and that may be something that that's that's helped us. There are things you can find online that can be helpful like mindfulness exercises can be useful for dealing with stress, but I think continuing the sense of of working together to support each other is one of the critical things we can do.

PRESIDENT VIVEK GOEL: Great. Thanks. And Zahid, I'd like to go back to your point about averting a fourth wave in the fall and, certainly, I think everyone agrees that we have to continue to work at the vaccination efforts, but what other public health measures do you see is going to be important?

ZAHID BUTT: Yeah. I think it would be really important to do, you know, asymptomatic testing or, maybe, repeated testing for people who probably live in high-risk neighbourhoods. Trying to see like whether how much of the population immunity is there and especially that definitely relates to your vaccination coverage as well and, I think, what we need to really do is to improve our contact tracing as well because that hasn't been something that has - is very good, or it hasn't been implemented that well, so contact tracing and testing is important. Another thing we have to think about is travel because, you know, you would prefer people to be fully vaccinated to come to Canada. And then, obviously, if those who are not vaccinated, then you need to quarantine them. So those measures have to be, you have to really balance out if you're going to prevent that fourth wave, otherwise it - we're trying to avoid the repeat of a fourth that happened like last year. So I think contact tracing, repeated testing and definitely looking at travel - how you're going to manage people entering to Canada, would be one of the one of the few of the measures that you can take to minimize, I would say, the risk of the fourth wave.

PRESIDENT VIVEK GOEL: Thanks for that and I think it really emphasizes an important point. We have a tendency, I think, to focus on one intervention at a time, so now everyone's focused on vaccination, but what you're really saying is the bread and butter. Public health work continues to be necessary even as we get the vaccination program done. So, we'll turn to the questions coming in in the chat, as well as the ones that were submitted. And, Kelly, you mentioned the 12th and up group, but we have viewers that are quite interested in what's going to be happening for the under 12s and what you think would be the timing for that to start to happen yeah.

KELLY GRINDROD: So, I am very interested in this too. I have an 8 and 11 year old and I just want them vaccinated and back to normal—so, I get this question. We had some interesting news the last couple of days though that this may, we're originally thinking that it would be maybe September into October that we would have vaccinations, so probably the ages five to eleven. Trials are ongoing right now in ages 11 and under, including down to six months old. But, given the myocarditis risk that emerged in the 12 to 26 range, especially in men and and teen boys, those companies—Pfizer and Moderna—have now gone back, we've just heard in the last couple of days, to seek permission essentially or to notify the regulators that they're expanding the trials to have larger trials. Larger trials mean they have more power to look at safety and they're actually expecting the results for these larger trials in the 11 and under group probably later in the fall, even as late as January of 2022. So, this actually could quite possibly delay the vaccination for the 11 and younger, which is all the more reason why should we should really be doubling down on the 12 and older because we are seeing from other studies that when kids do get COVID they can bring it into the house, especially with a delta variant, and they can actually transmit it throughout the entire house. So, you want to try and get the entire household as protected as possible, especially around those who cannot be vaccinated yet.

PRESIDENT VIVEK GOEL: And I think it's worth emphasizing the point that you made about looking at the safety issues in these trials and the children, because I've certainly been asked this: "Why were the children left out of the trials?" But this is the way vaccines and new drugs are always tested, right? You start with the adults and you work your way down to the most vulnerable populations last. It's just, in global pandemic, everyone wants it to happen right away.

KELLY GRINDROD: The science can't be fast enough for people, absolutely.

PRESIDENT VIVEK GOEL: But the approach is meant to keep our children as safe as possible from new drugs that may have inadvertent effects. So, we have another question about vaccinations and this is about the need potentially for boosters, maybe at six months or later, and what that will mean for people who would have had their first shot a few months ago, starting later in the year. And so maybe Kelly, I'll ask you to start on this, and I know there's also a global perspective on this and so I'll turn to Zahid after.

KELLY GRINDROD: Yeah, so there's a couple of things we're looking at. So people, when we're talking about vaccines, one of the reasons that they'll delay is they'll say, "Well, I want long-term data on safety." But actually, safety data for vaccines is short: it's six weeks after a vaccine. That's when you expect to see side effects. We aren't expecting long-term side effects from vaccines. What we are expecting for the long-term research of vaccines is, "How long do they work?" "When do you need a booster?" So, based on antibody studies right now, there's some thought that we might want a booster around six months, in theory, but there's other types of immunities. So, there's t-cell immunity that might actually take over and provide really good coverage. So, we saw headlines a little while back that Pfizer was looking to have a six-month booster, but that got a lot of public health experts and governments kind of responding and saying, " Well, just hold on. We need to actually look at whether this is needed." So, I suspect what we're going to see is following countries like Israel and France. For example, we may see a third dose offered to people who have a poor immune system: transplant, cancer—so going through chemotherapy and certain blood cancers for example. We may also see that in older populations. So, when we are looking at breakthrough where someone's fully vaccinated and still ends up in the ICU, often there's a reason like dialysis, for example, transplant cancer or being over the age of 80. So, we might see third booster doses in that particular population, but in the context of global vaccine scarcity we may not actually see third doses for the majority of the population for in the next six months, for example. And this is probably a good point to turn to Zahid.

ZAHID BUTT: Yeah, so globally it's been very interesting because, you know, it has been, if you look at it, a supply issue, sort of globally. And then, depending on, you know, what vaccines you're you're getting and their efficacy as well. So, what we are seeing now in a lot of countries that it's turning into a pandemic of the unvaccinated, which means that either you don't have the vaccine or you have the first dose but you're actually waiting for the second dose. And if you look across the border as well, in the US, you're seeing that surge in the in the number of cases, and that's primarily because, you know, a lot of people are there are unvaccinated. So, the issue about the booster shot, the first is that you would need to do some studies to see whether what's happening with the immunity in the population, whether you have really done some, really do you have scientific evidence to go for a booster dose. It would be interesting to see whether whether for for vaccines that are not recognized by by WHO, whether do you need literally a booster dose, or do you need like to go through the full schedule of the of the vaccines in order to achieve that same level of immunity?

PRESIDENT VIVEK GOEL: And one other thing to emphasize on this is the government of Canada has signed contracts for every Canadian to get booster doses next year and the year after. And so, in terms of the part of the question that related to what is being thought about, that certainly the governments are starting to think ahead to the need, but as you're highlighting Zahid, the question will be if we have 80, 90 per cent of our population with two doses, would it be ethical for us to start to be doing third doses based on perhaps not strong evidence yet about what the level of winning immunity is, while so many people in the world have not yet had a dose at all? And that also has implications for getting travel restarted and some of the other activities that we will want to engage in. Just highlights the complexity of all of these issues that we're discussing. So, maybe turning back on mental health supports, and this is an interesting question. So many things have obviously changed through the pandemic, including how we do events such as this. And so, John, could you talk a little bit about what you're seeing as the impact of the move to remotely delivered mental health care and what you see as the outlook for these types of services, perhaps to help meet unmet needs in the future?

JOHN HIRDES: Yeah, well again, the story is a little bit complicated based on a variety of changes that have happened in mental health service delivery. So, if we look at what's been reported about health service utilization in general: at the start of the pandemic, the March to July, 2020, time period, what we saw was a huge drop off in use of health services. We saw reduced emergency department visits, reduced surgeries, reduced primary care visits. I've just done some analysis that says the same thing happened in terms of psychiatric hospitalizations. There was a big drop off in in that time period, but it was selective in the sense it was mainly people with depressive symptoms that were less likely to come in for those services. The question is, "Did they get picked up elsewhere?" Well, the drop-off in primary care visits probably meant that they weren't seeing family doctors, and I'm not sure that as a society as a whole 
that we've done as well as we might in picking up the virtual health services. I've personally had a very good experience with a virtual clinic visit that I've been waiting for 10 years to get, and did great things for me in in the in the fall. But, I'm not sure that that's been the case. That was a specialist visit, whereas I had great difficulty in getting a primary care clinic visit set up. One of the things that we did well at the University, as part of the president's advisory committee on student mental health recommendations, we put in place new, virtual mental health services prior to the pandemic and and those are being used by our campus community. We did see the drop-off in counseling services as well in terms of the in-person stuff, but there was some pick up of that that virtual side of things. I think there's tremendous potential in in virtual visits. I find, in working with my grad students, we can have pretty good one-on-one conversations. So, I think it's a technology that will continue to develop after the pandemic and may turn out to be one of the benefits of having that kind of clinical service delivery become a normal part of services and a way to increase access to mental health reports.

PRESIDENT VIVEK GOEL: Great, thanks. So, that's interesting. It was already something that had started in terms of launch virtual services, and we now demonstrate it—that people can use it.

JOHN HIRDES: Yes, absolutely.

PRESIDENT VIVEK GOEL: And built on those learnings. So, our next question, Zahid, relates to a point you actually just made about people with partial, full or partial vaccines with unapproved health Canada vaccines and questions around mixing of doses. And so, perhaps, maybe Kelly, we'll start with you around the pharmacology aspect of the mixing of doses and then Zahid on the public health side.

KELLY GRINDROD: Yeah, so when we're mixing there's a few different ways we can mix. The one that we're talking about the most right now in Canada is just interchangeability of mRNA vaccines. We don't even really call them mixing because you're not so much mixing as you're having the same kind of vaccine; it's just two different brands. We went through this in Canada a bit earlier with AstraZeneca, which was a viral vector vaccine, and then people had the option to follow it up with a second viral vector so they don't mix or to follow it up with an mRNA vaccine where they do mix. And actually, interestingly in the US, this question is starting to come up now because the Johnson & Johnson single dose vaccine, it appears there may need to be a booster there; the single dose may not cover as well as we need for the variants, including future variants. So, that's a viral vector vaccine like AstraZeneca and they're looking at the possibility of an mRNA booster, for example. So, there's that option. Now much of the world, AstraZeneca was meant to be the world's vaccine. It was the easy to transport, inexpensive global vaccine. Unfortunately, it had the side effect, the vaccine induced blood clots. That was a major setback, but that's similar to the vaccine that we have in Russia as well, that the Sputnik vaccine is also a viral vector. So, there's that question there, but then there's this other type of vaccine that we're seeing. The Chinese vaccines, Sinopharm, for example, are inactivated vaccines and activated virus vaccines. These are like the more typical or traditional flu shot vaccines and are actually not as effective as the viral vector or the mRNA vaccines, or they've never been head to head, but from what we can see in the trials like with flu shots, they tend to have less efficacy whereas these new technology vaccines, mRNA, are wonderfully effective. So, that's a question that really hasn't been answered yet, is if you have someone who's had, say, the Sinopharm vaccine, when they come to Canada, like we did with the viral vectors, should we also offer a booster there? Is it needed or should Canada be recognizing a full vaccine schedule, someone got two inactivated virus vaccines, for example—do we as a country recognize them as being sufficiently vaccinated? And these are questions that aren't fully answered yet. 
It's not just WHO recognizing vaccines, it's the country of Canada also recognizing these vaccines.

PRESIDENT VIVEK GOEL: Do you want to add any perspective?

JOHN HIRDES: I think, as Kelly said, we have to really decide on, you know, when people travel from these countries where you have these vaccines that are not approved, whether you're going to provide them with a booster dose or whether you're going to put them on a full vaccine schedule, because obviously unless you do some antibody testing, you know, to trying to see their immunity level when they when they enter into Canada, you are not able to assess their their their vaccination status. So, in a way, if you're looking at allowing people entering from countries that don't have these approved vaccines, you might need to give them a booster shot because you are thinking that there might be some boost in their immunity because you have used a better or more efficacious vaccine while entering to Canada. Otherwise, it's going to be the same as unvaccinated people who have to then quarantine.

PRESIDENT VIVEK GOEL: Yeah, and we're going to come back to this issue because I know there's a question in the operational update in particular for what's going to happen for our own students. But it is important to emphasize that there's the health Canada approved list of vaccines and there's a WHO approved list of vaccines, and then there's vaccines that aren't on either. And then every country, or the united states has the FDA list, the European union has their list, every country has a slightly different list based on which vaccines were available to them, when. And as much as we're talking about people coming into the country, we know, from the news even today, this is a big issue for Canadians who will be going abroad, who might have had the mixing of AstraZeneca and mRNA, which is not recognized by other countries. And part of the question was around what progress is being made about resolving those issues. And I'll just say: we're public health and pharmacy experts here. These are geopolitical questions, and maybe another time we'll have a panel discussion with colleagues who can speak to some of the other types of discussions that are underway globally, but I would say if Canada is starting with the position we're only going to recognize health Canada vaccines, you can also see why other countries are taking the same position, and there's going to be quite a bit of negotiations that will have to be undertaken to get to a common place on this, and that's going to mean barriers potentially to travel for a little while longer. So maybe turning back to the youth or younger population and the risk of side effects, and there's, this question is saying that some people, including people from our local universities, have raised concerns about whether there's enough benefit in vaccinating the 20 to 29 year age group, given the risk of side effects such as myocarditis, and people are also worrying about other potential effects such as on fertility or safety in pregnancy. And so, questioning the value of vaccinating younger people.

KELLY GRINDROD: Yeah, so Myocarditis, just for those who don't know, Myocarditis is inflammation of the hear. It can also show up as something called Pericarditis, which is inflammation around the heart. And this was a side effect that showed up when we started vaccinating younger people. So the Israeli military, for example. The US military, for example, where they had younger men. And so this is a side effect that largely, not entirely, but largely affects teen boys and young men up to about the age of 26. And usually symptoms of it would include some chest pain, some shortness of breath. Now the thing to know about myocarditis that's interesting is it happens with flu viruses, it happens with COVID. It's when there's, you know, you have an immune response, for example, in your body, and sometimes you can get this this inflammation in the heart. Most cases we actually have no idea it's happening. It's not reported. People might have a bit of these symptoms and never have it assessed. It's very fast to diagnose with an ECG. We treat it with over-the-counter pain relievers, actually ibuprofen, at higher doses among others And so, this is something we're familiar with. This is not the same as what we saw with the AstraZeneca blood clot side effect, which was new to us, which we really had to learn very quickly and was very concerning. This is a little bit different because most cases of Myocarditis in young people have been mild, managed at home, resolve on their own. So, the question though was, "What about the risk benefit?" And we've seen a number of groups, we've seen this happen in Canada and the US, as well most publicly, weighing the risks and the benefits. And again, keeping in mind COVID can also cause some of these complications. So, the conclusion of these analyses has been: the benefit of vaccination still absolutely outweighs that risk or very heavily outweighs the risk of the vaccine, because again this is a rare side effect and is most often mild. Now, the other ones that are coming up though are pregnancy and fertility. So, there is no evidence that the vaccine impacts fertility, and that's been a big barrier. That misinformation, which is actually also disinformation, which is when people intentionally share the wrong information, they often will target fertility when it comes to vaccinations. This has been a big barrier. People are hearing this and they need this address before they're comfortable getting vaccinated, especially parents if teenagers need this addressed and people in their 20s. There's no evidence these vaccines impact fertility. The same question has come up with many vaccines in the past. Over and over again we've shown that these vaccines do not impact fertility. There's no evidence for this. The last one is pregnancy. There has been growing evidence, so there were people who actually got pregnant in the clinical trials. They're not supposed to but they did, in similar numbers to the placebo and the vaccine arm. It's been safe; they've had good outcomes with those pregnancies. And a number of health care workers early on did choose to get the vaccine and there's been a lot of tracking of their pregnancies. There's no evidence that there's any change in outcomes like miscarriage or anything like that, and in fact COVID can be quite dangerous in pregnancy, and that's what's led many groups to actually recommend that people who are pregnant get the vaccine. So, these are all common concerns that we're working through but, for people who are still on the fence about this, these are great conversations to have with a doctor or a pharmacist.

PRESIDENT VIVEK GOEL: And I just want to add on on those points that, from a public health perspective, when we're looking at the benefits of vaccination, we certainly want to look at those risks of side effects and adverse consequences. But, we also have to look at the benefits as well, and COVID-19 as a disease can cause many of those same things. And certainly, with pregnancy, we saw that there were very severe impacts of the disease on pregnant women. I remember a time back in the spring where every ICU bed at Mount Sinai hospital in Toronto was a pregnant woman. And so as much as we might be concerned about, and in this case it's disinformation, but even if there was a small risk we also have to think about what would be the risks of getting COVID-19 and the impact for that women. So I think the the last question we've already looked at, which was besides vaccination, "What are the other reactions necessary to minimize the risk of a fourth wave?" Was there anything you wanted out on that Zahid?

ZAHID BUTT: No, I think we covered it in a sense that, so one thing is important, as I said before is that we have to continue testing. We have to continue doing even like asymptomatic testing in in workplaces or maybe in schools as well to trying, to know. And on top of that you could also do zero prevalence surveys, which are like surveys to gauge the population immunity, to know really, you know, what what is the situation, whether you need to add some restrictions or whether, you know, there are other things you need to do.

PRESIDENT VIVEK GOEL: Great, so I'd like to take this opportunity again to thank all three of you for sharing your time with us and your thoughts. As well, not just this afternoon, but I know all of you have been very active in your own research and your work. When I read the clippings I will see you commenting on various aspects of COVID-19, so thank you all for your contributions to to the community and their understanding of what's happening. So, we're going to move on to the next segment of the program, which is an update on our campus operations, and I'm very pleased to welcome Jim Rush, vice president academic and provost. Jim.

JIM RUSH: Thanks very much, Vivek, and welcome to everyone who's joining us. I'm going to give a few operational updates about the campus and its operations, as we anticipate them for the fall, and some try to explain some recent guidance and information we've been provided with. I'm going to start at sort of a general level and then get more specific. So, I think it pays for us to remember that since march of this year, mid-march of this year, that the University's been planning our fall 2021 around a scenario where we were assuming a 50 percent capacity limit for our scheduled in-person teaching, and then we were using the overall capacity of the campus to accommodate that as a general planning principle. And we established a mix of online and in-person teaching and services by discussing with the faculties and other units about how that could roll out and stay within those those general limits. Many of you will be aware that on July 16th, the Ministry of Colleges and Universities, or the province of Ontario, signaled that the post-secondary institutions could use interim planning assumptions of lifted restrictions of physical distancing and capacity limits for in-person instruction and for on-campus activities in the in the fall. There were a number of assumptions that were built into that communication though that are that are worthy to remind everyone of, and those assumptions revolved around continued progress with vaccination and continued improvements in public health measures and in health care indicators. The Ministry has committed to providing a more comprehensive and more specific guideline in the coming weeks by early to mid August, and that will come in the form of what will be called an "Updated Post-secondary Education Public Health Measures Framework," so we're anticipating that as another point where more specific or more concrete guidance will come, but even then the framework itself and the communications that have emerged so far rely on public health guidance from the federal and the provincial and importantly also the local levels that will influence how those things actually get implemented. So, I think it was, it's important to remember that context for the direction we're going and the it also helps explain why some answers can't be as concrete today as they will be over the coming short period of time, of weeks. So, we can expect some health and safety cautions and measures to remain and even within the framework we'll continue to follow a public health guidance, and safety advice in direction as it emerges. We will, prior to September, be releasing a comprehensive continuity of education plan, which is actually an instrument that the ministry will require of universities to file but it will also be an important communication tool for the campus because it will be fully transparent and available, and it will be an integration site for for understanding safety and health protocols that are in place, and our plans should, the guidance on public health or safety change in terms of continuing operations if there is a backward step that emerges. With that in place as context, our overall, on the academic side of things, our overall academic delivery plans are not going to be universally changed. We're still anticipating a mix of online and in-person activities. We're not giving a general or universal direction to change course with the guidance as we have it now however what we do want to support is where it is feasible and desirable to do so, if guidance does continue to emerge that is in the direction of lifting restrictions for physical distancing and capacity limitations and where scheduled in-person activities are already happening with the old restrictions, that we we could imagine supporting modifying the capacity limits that were based on those previous guidance as the guidance emerges to be able to provide more in-person academic instruction in those formats. And faculties are working on plans of identifying where those feasible and desirable elements may exist should we have the freedom to do so. We have to continue though, in this planning, to recognize the need to be in the position to modify back should the guidance change in the opposite direction, and so that's the tricky thing about giving a specific answer now, is the uncertainty of that over the coming weeks in the guidance that, the specific guidance, that still is to come. In any case, remote learning options for core and progression elements of our academic programs were a principle of our original planning that we needed to maintain and ensure that they would be delivered no matter what the conditions are and that principle still stands. As guidance does emerge though, and if restrictions do begin to lift, and if we are able to follow that path, we'll be looking to expand in-person student experiences and services in conjunction, and other operations of the university frankly, in conjunction with that general guidance that that will emerge. On that note, we anticipate that some important contributors to those kinds of experiences and activities such as athletics and recreation, the library, dining and food services and other support services that are present on campus, will continue with scalable plans that take into account the potential lifting of restrictions to scale operations to serve the on-campus community at the time as we get to greater and greater certainty on these issues. Similarly, due to the positive trends that seem to be on the horizon, and when it is certain that we can move in that direction, that will create the conditions that would allow the possibility for the safe staged return of employees to happen at a rate that could be faster than was originally planned with more restrictive planning assumptions when that return to work from campus plan was originally articulated. We will however, of course, recognize that a tremendous amount of flexibility will be necessary to implement that plan as it exists now and with changing conditions and leaders and managers as they're contemplating the scale for the return of the workforce to campus, we'll be continuing to be mindful of personal circumstances and the conversations uh that are necessary to enact those measures. Currently my understanding is that leaders are having conversations with team members about the return to campus plans and that, as of the middle of last week, about three quarters of those conversations had taken place, and they are still scheduled to be completed by the end of July, so roughly the end of this week. And the return to campus team indicates that currently approximately 50 per cent of employees are, will be returning to work from campus in September for at least one day a week. On the vaccination requirements issue, the community will be aware that that the University has taken the position that will require students living in our residences during the 21/22 year to provide proof of vaccination against COVID-19 and students are currently communicated with about the parameters that surround that. That decision was precipitated based on guidance that was issued from our Region of Waterloo medical officer of health and the University, and our sibling institutions in the region that fell under the same direction from our regional medical officer of health responded in a coordinated way to that recommendation. In terms of general vaccine requirements we continue to strongly encourage vaccinations for all groups but do not currently require vaccination for students and employees to come to our campuses, outside of the residence dwelling students because of the congregate living arrangement and the order from the from the medical officer of health. We are of course, as in all operational issues, continuing to be in a position to be prepared to respond to advice from government and public health officials, including the local situation if the stance or specific direction is provided. In a slightly longer time scale, looking forward to the winter of 2022, if trends do continue in the positive direction, and as clarity comes over the coming weeks about the certainty of that positive direction, we can expect more activities and experiences returning in the new year, and in fact the planning principle that faculties in the Registrar's Office are currently using is a regular academic scheduling process for winter 2022 academic planning without restrictions. So, we will continue to update the community regarding winter 2022 plans after navigating the next several weeks of establishing the certainty for our fall 2021 plan, so we will continue to be updating and providing information as we know it, and as we bring all stakeholders along. So, thank you for the opportunity to share these updates. I look forward to the discussion that will come with questions and follow up later, but right now I'd like to turn things over to Charmaine Dean, vice president research and international, to provide an update on research operations.

CHARMAINE DEAN: Thank you, Jim, and let me add my thanks to everyone for joining us here this afternoon to hear about the campus updates and return to campus for the fall. The stage 3 or step 3 changes on the research side are very welcome, welcomed by our community, welcomed by our office, welcomed by the faculties and the department chairs. As we are transitioning into stage three, much of the oversight of on-campus research will be handled by the department's chairs and faculties. There continues to be an important role played by the safety officers in advising department chairs of various issues related to safety and management of the labs, but the lab management is all going to be conducted now through our department chairs with issues raised to the faculty level. As well, we no longer need to use the very lengthy safety templates that have been in place for the last 18 or so months. The safety templates are, as I understand, currently being revised to follow the new guidelines and they're very very short: one page, one and a half pages, with much of the detail that was required earlier now being omitted. So, this slide talks about the changes in terms of domestic, in-and-out of province field work, also transitioned into the hands of department chairs and faculties, dean's offices. As well, domestic visitors will be handled through department chairs and the faculty offices, and inbound international research visitors and undergraduate students are also being handled at the departmental level. In terms of what's accepted here, the graduate student and postdoctoral affairs office will still continue to manage international graduate either visiting students or postdoctoral fellows. So, graduate students visiting students and postdoctoral fellows will be handled through GSPA. Human participant research, as you know, has a special process in involving the research ethics board, and over the last 18 months a joint initiative between the research ethics board and our safety office, and that will continue to be in place except for really low risk cases. So, the safety office will still be engaged for much of the human participant research that's on campus and off campus, but in particular for vulnerable populations. As well, domestic field work that involves vulnerable or restricted populations, or when travel restrictions are in place for the destination, that will also continue to be handled through the oversight of our central OR office. And what does that mean when travel restrictions are in place? So, as COVID rears its head in local communities, there may be, as we evolve over the fall, differential restrictions for different communities. And so, when that is in place, then our central office will assist in understanding how travel can take place. As you've heard earlier, approval for domestic travel will be handled through the faculties. The Office of Research and Waterloo International, in collaboration with the Safety Office, and ultimately the provost's office approval, will continue oversight of international travel requests. And there, as you've heard from the previous discussion on vaccinations, there are a lot of issues that need to be handled, including that we need advice from the federal government as well as our local health authorities on how we handle the international travel for outbound. We anticipate to hear from the federal government on this issue in about mid-August, but it is an evolving file. And although we may have some news mid-August, it will probably be a longer term again through September before we can give clearer direction on this particular portfolio. So. I will now turn things over to Marilyn Thompson, our associate provost, human resources, to help us through the question and answer period. Marilyn.

MARILYN THOMPSON: And thank you Charmaine, and welcome everyone. Thanks for registering for the forum, but also thank you for all the questions that have been coming through the Q and A part of the live stream. Please continue to submit your questions. We've received more than a hundred questions already, and our conversation will be a combination of those questions that came in before the forum started as well as those that have come in since. I would ask that you use the Q and A for forum as a place for questions and not as a chat room. We wouldn't want your question to get lost in a stream of conversations. We have people who are moderating the questions coming in and we will try to get to as many questions as we can. And we have a group of senior leaders ready to be answering your questions as you come in as well. So Vivek, not surprising the theme of vaccines have been coming in through those that have registered as well, and in particular, why we're requiring vaccines for residents and not for everybody who's returning to campus.

PRESIDENT VIVEK GOEL: Well first of all, Marilyn, thanks for moderating this part of the session. So I can take part along my colleagues in answering the questions. And so, as Jim indicated in his update, the decision to make vaccines mandatory in residences was based on the advice and the very strong recommendation that we received from the regional medical officer of health. And I had an opportunity to discuss this with her. The rationale for providing that advice which was based, as Kelly described earlier, on what was being observed in our own community here in Waterloo with the outbreaks related to the Delta variant that started in June. And in particular, many of the earliest outbreaks were in what's described as congregate living settings, homeless shelters in particular. But she certainly sees that the residences have similar characteristics and are also congregate living settings. The students are in very close quarters for prolonged periods of time. So, when public health is making decisions and recommendations like this they're always weighing what the consequences are, what the benefits are going to be, and so in mandating it in the residence population, we see strong potential for benefit because of the very high risk of the outbreaks in the congregate living settings. In other settings in society, if we read the newspapers or listen to news we know that there is very intense discussion on whether or not there is the necessity for vaccination. My own view is, I think if we're going to continue to see the discussion around that until we can see whether we can get to the vaccination levels we'd really like to see. And again from a public health and ethical perspective, if we're going to naturally going to get to those levels without having to make it mandatory we're likely not going to see a government putting in regulations to make it mandatory. But as Jim, again, said, the circumstances could change if we don't see those levels of vaccination going up and we see the kinds of risks that Dr. Wang saw with respect to our residences, that public health advice may change. So, the bottom line is our decisions are really driven by the advice that we're getting from our public health authorities, both local provincial and federal, and at this time the recommendation has been around vaccination and residences. That's what we've proceeded with, and we'll continue to be part of the discussions around the other settings.

MARILYN THOMPSON: Okay, thank you. I'm going to ask the next question of Chris Read our associate provost students, and it's concerning international students. And the question that's come in is, "Will international students be encouraged to get vaccinated once they arrive?"

CHRIS READ: Thanks a lot, Marilyn. I appreciate the question. The short answer is "yes" 
; they'll be encouraged to get vaccinated once they arrive, if they haven't been able to do so yet. As we've heard from members of the panel and the president the provost today, we're strongly encouraging everybody to get vaccinated. But, specifically on the question of international students, and even more specifically as it relates to the residence environment, our position is that students living in residence can receive any COVID-19 vaccine authorized by Health Canada or any WHO approved vaccine. So, there are a couple other important things to mention here, and that's, that international students are eligible for the same health services and provisions as Canadian citizens and permanent residents, and that includes vaccines. It may be the case for some students, international students, that they're unable to receive one of the approved vaccines before the move-in period. In that case, we'll make interim accommodations to make sure that we support the beginning of that vaccination process. So, I think that answers the question, Marilyn, but of course we continue to be eager to provide all the supports possible and that we can for our international students so that they can join us in person if that's what they wish to do. Back to you, Marilyn.

MARILYN THOMPSON: And Vivek, would you have something else that you would like to contribute?

PRESIDENT VIVEK GOEL: I just want to clarify a point because I know I've had this question raised. Because, in terms of the federal government's requirement for border entry, it is the Health Canada approved list that they're looking at, and so if we have one of our international students coming in who has not had a Health Canada approved vaccine but one on the WHO list, they will still have to go through the 14-day quarantine period. And I know Chris's team is making plans or has plans to ensure that they can do the 14-day quarantine, but the Ontario ministry of health has said, with respect to recognizing vaccines, we will recognize the WHO approved list. So, it's, they will still, there has been some confusion because for the border entry they are not exempt from the quarantine as of yet, and, as we talked earlier, that's where there's lots of negotiations between governments going on about trying to come up with a uniform list for recognition.

MARILYN THOMPSON: Okay, thank you. And Jim, we have students that are coming back to campus and they're eager to come back to campus and be in class and with their colleagues and with their faculty members, and we've had questions coming in with respect to the Fall semester. I know that you mentioned that as circumstances improve we will look at more in-class course offerings, but for the Fall semester we've had a question come in that asks, "If things do improve and courses are set to be remote, can they change, and they change to in class presentation for the fall?"

JIM RUSH: Thanks, Marilyn. Yeah, it's an important question. There's, again, a lot of context around it, because although the interim guidance that's emerging from the MCU statement, I already mentioned some of the qualifications on that and the things that would have to fall into place. And I think the MCU in its guidance, in that memo, recognizes that the timing constraint we're under because by the time we do have more concrete guidance in clarity, we'll only be weeks before the beginning of the term. And so, although technically we'll be able to move in that direction and some activities over the term, we also recognize the decided impact that making universal changes based on this interim guidance at this time could cause challenges for our whole community students who have made decisions about where they're going to live, or international students that are located in other countries that can't join us, and faculty and staff frankly that have put weeks and months of planning into the preparation for delivering courses using a guidance that was in place make it very difficult to imagine switching from remote offerings to in-person on mass. Now having said that, there are opportunities, again, where it's feasible and desirable for individual programs to take advantage of improving guidance if it's, if it does come. For instance, you could imagine an already in-person scheduled class or lab section that was using physical distancing and capacity limits based on our previous assumptions could now remove those limits to serve in-person teaching and learning to more students in that section, and that may be a logistical example. It may be both feasible and desirable for a program to do it, and it will enrich the academic and learning experience for those students. And there may be some other opportunities like that within parameters that don't disenfranchise students that can't be here for either decisions they've made or because there are barriers to them attending. And that was part of our original commitment in the academic programming for the fall as well, was to always be able to provide the core and the progression elements of the academic programs to students no matter where they were going to be in this term. And so, we'll make changes where we can but we can't give a universal direction to do that, especially with the uncertainty in the timing.

MARILYN THOMPSON: Okay, thank you. And of course, Vivek, we're returning our employees to campus. And around the world there's been talk of the pandemic being a big reset, reconsidering our workplaces and how we view our workforce. The University already had a work from home policy, which allowed for up to two days a week working remotely. We've had questions come in from our employees asking if we're willing to reconsider and expand that maybe even to the point of employees being able to work full-time remotely. What are your thoughts on that?

PRESIDENT VIVEK GOEL: Yeah, so I absolutely agree that we are at a moment in history, and I think John referred to this earlier about the generational shifts that have happened with past generations. I think we're in at the same kind of moment in time, and John also talked about the shifts in health services provision that we've experienced. So, there's no doubt that we're going to be changing changes in our own environment, and how we teach how we do our research, and and that will have implications for how our employees do their work. I think the key thing here is right now, as Jim said, our focus is on the coming weeks and getting to the start of the Fall term, and then we'll be thinking about the next term, January. And there's a lot of work that everyone has to do to get through these next few months. As I said at the very start, while we're in a great period with the progression of vaccinations and the control of the COVID-19 spread in the population, there's still risks and other things that could happen with to be remain vigilant. All that to say, that we will get to these discussions about what the long-term future looks like, but it will come over the next few months and beyond. There's going to have to be discussions at the department level, at the program level in terms of what kinds of services are we're going to be delivering and what those individual jobs will look like. I know your team is also looking at a whole range of other implications, from tax issues and benefit issues: that people are no longer working and living in and living in our community. So, we have many considerations that many other employers are also working through as they think through these big shifts in society. So, absolutely agree that we will be looking at changes. Can we say that every employee will have the option to choose to work at home or not? I think the question did signal non-student facing employees, but we will have to work through role by role. But I do want to emphasize one point: while I see the very significant role that technologies can play and I'm a big fan of technologies, we are in a people business, right? And we've heard that very clearly from our students. They want to have the personal interactions. I think as well, in the kind of work that we do outside of our educational activities, in research, we know that there's some parts of the research enterprise that have been able to continue, but we also know that many research projects have been significantly set back by not being able to have face-to-face interactions. And the final point I'd make is, we've had a good experience, or as good as it could be, in the move to online and teams have been able to continue, but those were pre-existing teams relationships had already been established. It's been much harder to onboard new people, and I'm experiencing this myself as I come in from the outside, If you don't have the opportunity to have some of those face-to-face interaction, and if you want to build a team around a new project. And so, let's think about our graduate students, graduate students who might have been in their third or fourth year, knew their supervisor, knew the labs, they were able to continue to work remotely or to come in occasionally and not see their colleagues, but a new student starting this fall, looking at four or five years, if they never interact with anyone else what kind of experience are we going to be providing for them? So, I just want to emphasize that we are, I think, always going to remain in some form having a face-to-face component to our work.

MARILYN THOMPSON: Okay, I think the singularly largest number of people asking a question that are online is, "Can we move to the model that University of Guelph has announced, working three days a week from home?"

PRESIDENT VIVEK GOEL: I might turn that back to you. But certainly, I'm not aware, I haven't had a chance to see that, so we'll certainly look, take a look at that policy.

MARILYN THOMPSON: I think one of the strengths of the process that we've been using is to have individual conversations with our employees, to ask them about their work, to look at what the impact would be if they were not on campus, to ask them, you know, from their perspective what would be reasonable in terms of working remotely, and I think that's the strength of the approach we've taken not across the board, you know. Here's what we're going to put in place, but to work with our employees to find out you know what's happening with them. They know their work best, and to, it's not a one-size-fits-all and not everything will look the same, but I think we're looking at, you know, the best academic experience for our students, which is what they deserve when they come here.

PRESIDENT VIVEK GOEL: Yeah, and it's a little bit like Jim's answer on or comment about the changes for the classroom, so we want to do it at that individual level as opposed to a blanket three days a week.

MARILYN THOMPSON: And some questions from our faculty: "What if faculty don't feel comfortable teaching in classes where vaccinations aren't mandatory?"

JIM RUSH: That sounds like a presidential question.

PRESIDENT VIVEK GOEL: Thank you, Jim. Again, as I said earlier on that, the response to the question of mandating vaccines, we're not, health and safety are our top priority and we will be monitoring what the levels of the vaccination are in our population as well as in our community around us and working closely with our public health colleagues, and if the levels of vaccination aren't sufficient then we will have to look at what other measures we might put in place. So, I think in terms of having to work in an unsafe environment, no, our commitment is to ensure that our work environments are as safe as possible.

MARILYN THOMPSON: We've had questions come in as well about the wearing of masks and Kate Windsor, who's our director of safety, has been focused on preparing the workplace for us to return to campus. So, i'm going to ask Kate this question, and it's from someone who expressed a concern: "I'm worried about policies that will require masks to be worn, and specifically how can we police mask wearing?"

KATE WINDSOR: Thanks, Marilyn. So there may be reasons why an individual is not able to wear a mask. However, we have a good, robust process in place for individuals to arrange for accommodations if they are not able to wear a mask. So, it is very important, so this applies to both students and employees, and so students, for example, won't be permitted to enter a classroom without a face covering that is properly worn. And ultimately, instructors could suspend the class if they choose to and follow up on that with the student. And so, for this reason, and it's very similar with employees to have those discussions with their occupational health and with their supervisors, to arrange those accommodations in advance. So, our expectation is that individuals don't arrive and not wear a face covering but do that, reach out to, depending on whether they're an employee or a student, to investigate those options and accommodations if they're unable to wear a mask. And I guess, just on the policing side of things, we will continue to monitor adherence to that and use internal measures including security monitoring of adherence to that. And again, encouraging everyone to do their part and encourage others to wear a mask if they see that someone is not wearing their mask properly.

MARILYN THOMPSON: You will know our office setups have a variety, from open workstations, to individual offices to shared offices. How will the university protect its members in shared office spaces when we return to campus?

KATE WINDSOR: Thanks, so, as has been mentioned, there have been some recent changes to recommendations with respect to physical distancing, so that has made things a little more confusing for leaders who are working through these processes. But, under the return to campus plan that we have been working through, leaders are looking at how to safely establish their office operations. So even though physical distancing requirements may shift or change, we'll closely monitor those and look at how to best advise leaders and managers to establish their workplace safety procedures. So, we were closely monitoring what is developing with respect to workplace safety. And in addition to physical distancing, which has been one of our key hazard controls for COVID-19 throughout the pandemic, we have our other controls such as hand hygiene, very robust cleaning protocols, screening employees and students prior to entering campus, and so on, so those will those are all a bundle of controls that help to protect workers in the workplace. And we also encourage, as always, workers to ensure that they speak to their supervisor if they do have concerns about safety in their work environment.

MARILYN THOMPSON: And Vivek?

PRESIDENT VIVEK GOEL: I just want to add to Kate's point that it's important that we respect our community and we treat each other with respect and dignity, and john referred to the social cohesion earlier that's been so important in helping us get through this. And so, I think as Kate said, let's use the tools that we have but not get into confrontations and having ill will towards our own colleagues.
 
MARILYN THOMPSON: Yeah, good point. Thank you. I'm going to call on Jeff Casello, our associate vice president of our graduate studies and postdoctoral affairs office. And this question is to you Jeff, "Will you offer grad students training on how to return to in-person TA-ing safely?"

JEFF CASELLO: Yeah, thank you very much, Marilyn, for the question, and thanks to all the attendees. We certainly think that graduate student safety is paramount, particularly when they are serving the University and their roles as graduate teaching assistants, so i'd like to answer the question in a couple of ways. First is, of course, creating the situations in which our TAs have the greatest likelihood of being safe, and that includes some continuing our process of remote TA-ing, remote office hours, virtual office hours, things that we've learned through the pandemic that have worked very well for our, both for our graduate students who are serving as TAs but also for our students who are learning from those graduate student TAs. Within the classroom, offering tutorials, the same rules that apply to instructors in terms of maintaining safety will be in place for our graduate students who are leading those tutorial sessions, so that will be in place. I think the one question that we are still working through is the creation of safe spaces for our graduate students when they are offering TA office hours in person, so I presume, and again we're working with the faculties to work through this, we will have spaces that are dedicated for the graduate students to conduct office hours where we can be consistent with whatever the public health guidance is at that time. Now turning back to the safety question, each year of course we have a TA orientation and we have modules that we we work through, and I suspect that for the upcoming Fall term, in addition to the normal return to campus training that the University is requiring, there will be specific elements that are designed for TAs to receive the training they need in order to make sure that they and their students are safe. So, thanks for that, Marilyn.

MARILYN THOMPSON: Thanks, Jeff. And Jim, we all listen to the changes that the provincial government announces on relaxation of requirements and listening to the federal government in changes to border restrictions. So, as we bring people back to campus, one of the things that they're highly anticipating is to be able to be with one another again. Do you anticipate there will be an increase in in-person events, or even visits to our campus?

Jim Rush: Yeah, thanks. Thanks for the question. Just another couple of pieces of context in the broader context of the province, we currently have the step three guidance that is, that is in place now, and with step three guidance comes guidance on gathering limits for indoor and outdoor settings for dining conditions etc. Many of the same kinds of activities that are in different forms take place on the campus, so we do have current guidance that is in place right now about those things. I anticipate that in the updated framework that will come from the MCU that there will, they will have to be much more specific on the category they identified as "Other on-campus activities" if there is going to be a specific guidance for campuses versus what step or stage the province is at at that time. So, again, until we have the concrete guidance I can't tell you an exact answer. I can tell you how we'll handle the problem as the guidance becomes more and more concrete. We'll work through the layers of complexity that will come through, and our focus in the first layer will be on the academic programming implications, then the student support experience and campus operations impacts of changing guidance and how it will affect the question you're asking, then we'll be looking at our campus activities and events, and then I think after that would, I think, become our rationalization on what it means for large groups of visitors in much in more public events that are of a larger scope and scale. So, I think there'll be a progression of information and guidance that will come on that in roughly the way that I described it and will, of course. We know the eagerness that all of our stakeholders on campus have for doing things in person and we know the eagerness to return to some of those things that enrich our campus life, whether it's in academics or research or other areas that involve bringing groups onto campus that aren't part of the community at the normal times, and we'll, we're very tuned into the fact that we, as we are able to, to provide more specific direction in response to the direction, frankly, that we get about what's what's inbounds and what's still too risky or would jeopardize safety and and health parameters that we need to have in place.

MARILYN THOMPSON: Okay, thank you. And Charmaine, the next question is for you. We're a highly collaborative university, and we like to share our experience. We collaborate on research, and sometimes that's through conferences, and we have questions that come in about, "How can we start planning, or can we even start planning travel to conferences and research collaborations, whether that be in Canada or overseas?"

CHARMAINE DEAN: Thank you, Marilyn. And I know everyone is excited to be able to get on a plane and do some short-term visits and engage in discussions with researchers around the world, as we had previously. The current guidance from the government on the short-term travel remains the same: to avoid non-essential travel. So, our current practice with regards short-term trips will remain the same. But as Jim and Vivek have noted, this guidance is going to change over the next few months. And as things evolve, then we will be able to make different decisions based on how borders open up. And as we heard earlier, there are also the complications on vaccines, what vaccines are considered eligible in different countries, and we'll be able to help our community understand how they can move around on these short-term visits. So, Marilyn, the current practice is in place, we do understand that there is excitement to get out and go out and we do know that the federal government is giving this a lot of attention, so there will be changes coming up in the short term. We'll make sure that everyone's aware as these changes evolve.

MARILYN THOMPSON: Thank you. We're a highly and research intensive university as well, and we've had a question asking whether there are plans to relax research lab and office space capacity limits in the fall.

CHARMAINE DEAN: Oh, thanks for that question as well, Marilyn. So, there will be changes, certainly. We know that occupancy limits are changing, but we also have to respect the local health authorities and the guidance from the local health authorities. So, I'd say be attuned for this right now. As I mentioned earlier, we are transitioning the lab management to the department chairs, the faculties and the faculty safety officers. We've already met about 75 per cent of the chairs across campus, had discussions with them about how we will move and operate, very soon, immediately in fact, as soon as we finished meeting with all the chairs. And as well, we expect that guidance on occupancy will also change, and that will be passed on to the department chairs. So, I think you can work with your department chairs in the future. Right now, it is 
remaining the same, but we expect this to change come September.

MARILYN THOMPSON: Thank you, thank you. We've also had a question about faculty who may want to continue teaching online in the winter because their young children are either unvaccinated or they're concerned about spreading the virus to their families. So, thinking ahead to the January semester.

JIM RUSH: Yeah, I think even the question has come up even in the past of what we would do for accommodations in a variety of scenarios. The important point I think is engagement with the program leaders and the department chairs to understand the concerns and what the limits and the possibilities of participation in the program are. There may be programs that by the winter, if guidance goes in the right direction, might be completely being offered in person, and it would be a negotiation to understand how that scenario would fit into what is required of the department to deliver a program at that time. So again, it's hard to give a universal answer to a question that's so dependent on the individual circumstances that are involved, both of the faculty member and of the work needs of the department where that person works, and what kinds of arrangements would have to be put in place to facilitate that and to replace the activity that would normally be expected to the faculty member.So, it's hard to give one answer to a question that that could be so multi-factorial at this time. But, I do know that department chairs and other leaders, as Vivek said earlier, that a very important part of us negotiating this as a community is open and communication with each other in negotiating difficult scenarios like is being articulated here.

MARILYN THOMPSON: Vivek?

PRESIDENT VIVEK GOEL: Maybe I'll just look at this from a broader public health perspective and build on some points that Kelly made earlier as well about young children. And we know that, as we heard earlier, it'll probably be sometime in 2022 before those younger children will get the vaccine. So, the way in which we're going to protect them is by keeping the number of cases in our community as low as possible. So, when you keep cases in the community low, they're not going to get spread around by any means. And so, we all have our part to do by for getting vaccinated, taking the precautions that are in place. But if we have that in place, again, the risk to children is really low, and that's why there is so much focus on getting kids back to school, because the risks for children to not be in school are very significant, right? And we know that they've had many significant impacts. And so, you know, answer to that question: like again, we would not be opening things up if there were those risks of transmission to different groups. As well I want to emphasize a point that, there's been lots of different information in the community, the vaccines are being shown to reduce the risk of transmission. So, if that faculty member is vaccinated, if the people around them are vaccinated, it's not as great as the protection that we have for severe hospitalization and for death for that with the vaccines. Even with the Delta variant, there's a study out from, or the latest results from public health England last week. It's showing protection against severe disease and death of up to 90 per cent for the vaccines, with the two doses. But even for reducing risk of transmission it's about 40 to 50 per cent, so the more people that are vaccinated the more we'll be reducing the transmission. So, to the faculty member that have that question: the more vaccinations we have, the lower the risk there will be for your children.

MARILYN THOMPSON: So, I guess, the messaging would be, whether you're a faculty member, a staff member or a QB member, have a conversation within your department with your manager within your program.

PRESIDENT VIVEK GOEL: Yes, exactly.

MARILYN THOMPSON. Thank you. The last question for the day I'm going to ask Charmaine, and it's, "How would you view potential impact on our research by the national security guidelines for research partnerships, and how should we respond to the guidelines in the best interest of academic freedom at the University of Waterloo?" And the last question goes to you.

CHARMAINE DEAN: Thank you, Marilyn. And first let me say, Marilyn, thank you for allowing this question to be brought forward, even though it's not a back to campus question, because it is been such an important issue for members of our community. So, first off, thanks for allowing it forward. Secondly, I'll say that iIshare the concerns of our faculty members on this particular topic. We have been in discussion with both the federal government and will continue to be, and with NSERC on the new national security guidelines, pointing out some of the issues of concern with the guidelines from our vantage point and from our faculty members vantage point. At the University of Waterloo, you know, partnerships are so important for us, and at this time as we emerge we want to accelerate them. This new security guideline and the assessment process has some challenges associated with it that are really important for us to address. I will say that members of our community have been in touch with me about this issue and I have reached out to them and we are currently organizing a meeting for us to discuss this, in preparation for a broader campus discussion where the vice president of research partnerships at NSERC has agreed to come to Waterloo to discuss the issue. So, if you haven't been in touch with me and you'd like to be at the preparative meeting please let me know, but then subsequently we will have a broader discussion on this on campus and we've been very fortunate that the VP research partnerships Mark Forte has agreed to come to address the issue.

MARILYN THOMPSON: Thank you. And Vivek, it's over to you to conclude the forum.

PRESIDENT VIVEK GOEL: Great, thank you as well, Marilyn, for having facilitated this part of the session. And I want to maybe just start by also saying a few words about that last question. It does tell us that there is more to the world than COVID-19. But it is a very very important issue, and it's one that I, as Charmaine knows, I was involved with as well in my previous role. And these issues that are being raised have been flagged for government from the very start of the discussions around national security and we absolutely want to support and meet the requirements that the Canadian government is laying out around security considerations. The safety and security of the country is of utmost importance. But as was indicated in the question, the the values of academic freedom, the role that universities our institutions play in developing partnerships and collaborations that help move research forward. But also, keep our societies connected, right? And so, even as there are tensions throughout the world, and we had this back during the Cold War, it was academics that maintained connections, and so that's a very fundamental role that our institutions play. So we have, do have to find a way of meeting the national security requirements while continuing to meet our objectives as an institution. The other part of the question though that is really important, and Charmaine I know is working with the members of the community that have raised a concern, is that the way in which these new security guidelines have been framed run the risk of profiling of certain communities, and that is something that is simply not acceptable. And we have made that very clear to the government and pointed out that this particular government has been very active on the equity, diversity inclusion file since they came to office in 2015, and that this particular action could have inadvertent consequences that would go very contrary to their own values around equity, diversity and inclusion, and so i'll be continuing to work with Charmaine, and both of us will be working with our colleagues at other universities, to make sure that this issue continues to be addressed. So, this concludes our question and answer period, as well as our session. I'd like to thank all of our speakers that have joined us. Charmaine and Jim, for the operational updates, and Marilyn, for facilitating the Q and A. I'd like to thank all the staff that have helped to organize the event. And I'd like to thank all of you for joining us and for posing those questions. I know at last count there were over 100 that had come in, it's probably more than that by now. And as I said at the start, we will look to answer those questions, posting on the website and in other places that as we're able to. So I'd like to thank all of you, and please stay safe, and I look forward to seeing everyone on campus soon.