health

Tuesday March 30, 2021

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Tuesday March 30, 2021

Canada falls behind on barcode technology for COVID-19 vaccine tracking

Millions of COVID-19 vaccines set to pour into Canada will carry a tiny barcode that would allow the package to be tracked all along the supply chain, and could even help to connect a patient’s digital vaccination record to a specific dose. That level of tracking is taking place in other countries such as the United States – but won’t happen in Canada because the country lacks the technology to scan those barcodes.

February 25, 2021

It’s a frustrating gap for those who have been pushing for such an ability since the 1990s. As a recent Deloitte report on the COVID-19 vaccination campaign pointed out, these barcodes can go a long way to “reduce errors and improve efficiency and safety.”

The technology is available – cellphones and tablets can scan these barcodes with the right software. But the barcode issue reveals larger problems with Canada’s fragmented and outdated health infrastructure – it involves 14 jurisdictions doing 14 different things, sacrificing efficiency for independence.

December 21, 2016

Currently, some provinces are tracking supplies by manually updating spreadsheets and logging by hand the lot number of administered vaccines. Ontario and Quebec have devised a more advanced database of their available vaccines, but it still relies on someone manually entering the serial numbers of vaccine shipments.

Other countries have figured this out: Vaccinators in the U.S. are scanning COVID-19 vaccine shipments and individual doses, allowing states to build accurate and timely databases of who has been vaccinated. Ireland and Turkey are also relying on these barcodes. The World Health Organization is encouraging every country to use them to promote efficiency and fight counterfeiting.

June 13, 2019

n Canada “should have been written in the pandemic plan.”

There was a plan to make these barcodes central to Canada’s public-health system, and there was a time when Canada was ahead in digitizing its health system “by a decade,” Dr. Van Exan said. Canada’s 1998 vaccine strategy first proposed barcoding vaccines to promote efficiency and accuracy. The 2003 SARS epidemic, and the creation of the Public Health Agency of Canada, hastened that work.

In normal times, Canada administers millions of vaccines a year for diseases such as mumps and influenza. Provinces slowly adopted digitized immunization records in the early 2000s, but continued entering all the data manually: Audits of some provincial systems found fully 15 per cent of immunization records were incomplete, nearly a quarter had inaccurate information, and crucial data was missing from one in five adverse-reaction reports. (Continued: Globe & Mail) https://www.theglobeandmail.com/canada/article-canada-falls-behind-on-barcode-technology-for-covid-19-vaccine/#comments

 

Wednesday December 9, 2020

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Wednesday December 9, 2020

Fauci Calls Coronavirus Vaccine a Game Changer, Decries Misinformation

Anthony Fauci said a vaccine could diminish coronavirus as successfully as the polio vaccine did for polio, enabling workers to return to offices and restaurants in the second half of 2021.

December 1, 2020

But hurdles exist, the U.S. government’s top infectious-disease expert said. They include people’s hesitancy to get vaccinated, a successful and swift vaccination program, and getting through a rise in Covid-19 cases that is now being fueled in part by misinformation about the virus, Dr. Fauci said at The Wall Street Journal’s CEO Council Summit on Tuesday.

“There are a substantial proportion of people who do think this is not real, that it’s fake news, or it’s a hoax. This is extraordinary. I’ve never seen this before,” he said. Dr. Fauci added that he will convey the following to President-elect Joe Biden’s administration: “We have all got to be on the same page telling the American public we have to pull together. That, to me, is the most important thing.”

Dr. Fauci and Deborah Birx, the White House coronavirus-response coordinator, who also spoke Tuesday at the summit, both reiterated their calls for people to adopt public-health measures to combat the spread of the virus.

August 7, 2020

The U.S. Centers for Disease Control and Prevention recently said the virus infected people in the U.S. in mid-December 2019, a few weeks before it was officially identified in China and about a month earlier than public-health authorities found the first U.S. case. It has since caused almost 15 million diagnosed cases and more than 283,000 deaths. Cases have surged since the fall, with more than 2,000 daily deaths being reported. It is too early to know whether the Thanksgiving holiday will add an additional spurt of cases.

The death toll could surpass 430,000 by March 1, according to the Institute for Health Metrics and Evaluation. The Trump administration is aiming to have enough coronavirus vaccine for everyone in the U.S. who wants to take it by the second quarter of 2021.

“We have to go head-to-head with the misunderstandings people have with this virus,” said Dr. Birx, who added that she doesn’t know what role she will have in the president-elect’s administration but will remain in federal government.

Dr. Fauci, director of the National Institute of Allergy and Infectious Diseases, was upbeat about the promise of a vaccine to bring coronavirus to heel.

June 17, 2020

Health-care workers and people in nursing homes and extended-care facilities will get the vaccine first, he said, followed by various prioritization levels that are likely to include seniors, people with underlying health conditions and workers with critical jobs, such as teachers.

Dr. Birx also said vaccines need to be prioritized for communities of color that have been hit hard by Covid-19.

Younger people and people with no underlying conditions will likely be able to get the vaccine by the end of March or beginning of April if the vaccination program runs efficiently and the majority of people take the vaccine, Dr. Fauci said. With about 75% of the public inoculated, there should be low levels of circulating virus and a return to workplaces.

The stringency of public-health measures will gradually diminish, he said, and chief executives should use surveillance testing once workers return to quickly identify any potential outbreaks.

“I don’t think we’re going to eradicate [Covid-19] the way we did with smallpox, but I think we can do what we did with polio,” Dr. Fauci said. (Wall Street Journal) 

 

Thursday November 12, 2020

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Thursday November 12, 2020

Doug Ford downloads hardest pandemic decision-making

Being a medical officer of health in an Ontario town or city has always been a big, challenging job. Being the MOH during a pandemic like this one is exponentially harder. Add in being the default decision-maker about what businesses can stay open and which must close, and you’ve got a job not for the faint of heart.

October 28, 2020

That is where Ontario’s medical officers find themselves today, with the provincial government apparently opting for a minimalist approach on pandemic policy at the very time when COVID-19 is spreading dramatically. At this rate, it will soon be out of control. It may already be.

On Wednesday, for the fourth time in five days, Ontario set a record reporting 1,426 new cases. The seven-day average stands at 1,217, the highest it has been since the pandemic began. Another unfortunate record: There are 10,361 active cases of COVID-19 in Ontario. And 92 long-term-care facilities are dealing with outbreaks, with that number expected to grow. Hospitalization rates remain relatively low, but if the current growth rate continues that is likely to change.

All this, even as Ontario labs processed 36,700 test samples, reporting a test positivity rate of 5.1 per cent. Health experts say a positivity rate of 3.0 indicates spread is at the tipping point toward exponential growth.

September 18, 2020

Why the provincial government chose this time to toss out the old pandemic control regime and adopt one that raises the bar on when provincially mandated control measures will be implemented is anyone’s guess. But from all appearances, the Ford government is putting keeping businesses open at the top of its priority list, even when doing so is not in the best interest of pandemic control.

When questioned about all this, Premier Doug Ford was quick point out that local public health authorities always have the option of imposing measures over and above the provincial guidelines. 

August 27, 2020

That stance puts municipal governments and their public health officers between a rock and a hard place. If you don’t believe that, ask local political and health officials in Peel Region and in Toronto. Both have implemented local lockdown measures because provincial measures were deemed insufficient under current circumstances.

Indoor dining and gyms, for example, are locked down for 28 days in both those jurisdictions. But now, instead of suffering businesspeople being angry with the province, they’re angry with local health officials and their municipal partners. 

May 16, 2020

In a way, this could be referred to as a new kind of provincial downloading. And like other forms of downloading, they serve the provincial government with little regard for the impact on municipalities and local health officials.

There is something to be said for the targeted approach to pandemic control. It is better overall than a one-size-fits all provincial solution, though it’s not perfect. But it does allow the provincial government to deflect responsibility for harsher lockdown measures.

Ontario is not in a good place in terms of controlling the spread of COVID-19. And that’s the cruelest paradox of all. Too many of us are sick and tired of pandemic restrictions on personal freedoms and commerce, so we slack off here and there, and the virus is ready and waiting for the opportunity. Now we are in the thick of the second wave, which is in many ways worse than the first. If we remain on the current trajectory, the most likely outcome is another hard lockdown like we experienced early in the pandemic. The Ford government won’t be able to dodge that bullet, and neither will the rest of us. (Hamilton Spectator Editorial) 

 

Wednesday June 17, 2020

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Wednesday June 17, 2020

Rosslyn residence was literally a house of horrors

The story of the Rosslyn Retirement Residence, as reported by Spectator journalist Steve Buist, is by turns sickening, heartbreaking and infuriating.

May 27, 2020

It is also, in a way, indicative of what is wrong with Ontario’s long-term-care system. But it is so egregious, so extreme, that it is in a class by itself. Buist’s series was entitled House of Horrors, and that’s not an overstatement, at least not for victims and their families.

Yes, victims is the right word. Rosslyn residents were subjected to chronic bedbug infestations. Photos showing the result of those infestations will make your stomach turn. Medication was often not administered properly. Residents wandered in unsafe conditions. There were mouse droppings and black mould in food storage areas.

Management and ownership of Rosslyn received repeated notices, from public health and the provincial oversight agency, and warnings about health and safety infractions. And these infractions were not all new and related to pandemic staffing. Between 2018 and 2020 public health inspections found bed bugs, mice and cleaning issues. According to former staff members, operators of the home portrayed it to residents’ families as having a “secure memory unit” that didn’t actually exist.

There’s more. You could fill this space three times over just with the disturbing findings and stories uncovered by Spectator reporting. Fourteen residents of the Rosslyn have died from COVID-19, 22 staff members became infected and more than 60 residents were hospitalized by the time the pandemic eventually emptied the facility last month.

Now let’s add insult to injury. The owners of this facility, and seven other retirement homes and residential care facilities in the Hamilton area, are no strangers to the business. The Martino family owned the Royal Crest Lifecare chain, which collapsed in bankruptcy in 2003. They cried poor at the time but were found to have access to four homes, five SUVs, three Mercedes, a Hummer and a 42-foot cabin cruiser. When the dust settled on the commercial and business bankruptcies, nearly $200 million in liabilities were left, and $18 million left owing to taxpayers.

April 1, 2020

And now, the questions. How was it that the Martino family was able to continue in the business of running retirement homes so easily given its terrible track record? Why would they be given a licence by the provincial oversight agency, the Retirement Homes Regulatory Authority (RHRA)?

In the past 18 months, the city’s bylaw enforcement department has registered 28 violations of property standards against the Martinos’ care homes in Hamilton. There is a litany of horror stories from former staff and families of former residents RHRA. Why did it take so long to act? The RHRA revoked the Rosslyn’s licence this week, but what took so long?

Then there’s the oversight agency itself. The RHRA is essentially a self-governing industry body charged with enforcing the provincial Retirement Homes Act. Given everything we now know about LTC in general and Rosslyn specifically, why should we trust an industry body to oversee the sector?

Last but not least is the prospect of criminal charges. Provincial NDP Leader Andrea Horwath has asked Hamilton police to conduct a complete investigation. Good for Horwath, but why didn’t the government do that first?

If an investigation finds the Rosslyn horror story involves criminal behaviour, charges must be laid and those responsible must be prosecuted. The Rosslyn travesty and others like it should be rallying cries in the call for complete reform of long-term care. Rosslyn’s victims deserve nothing less. (Hamilton Spectator Editorial) 

 

 

Wednesday April 1, 2020

 

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Wednesday April 1, 2020

Breaking down the COVID-19 numbers

Coronavirus cartoons

In a little more than two months, SARS-CoV-2, the virus that causes COVID-19, raced around the world and turned a handful of known cases to more than three quarters of a million, with at least 36,000 lives lost – reported figures that the scientific and health communities widely agree are too low.

The spreading virus has pushed numerous countries to scramble to lock down cities, shutter non-essential businesses, and close their borders to all but their own citizens, adopting some of the extraordinary measures executed in China that might have previously been unthinkable elsewhere.

Researchers and armchair epidemiologists alike are analyzing the trove of data to create models, find patterns and clues on whether curves are being flattened, which country is on a faster or slower trajectory, why death rates and ages vary, what measures seemed to work, and when the pandemic might end.

The flood of numbers and questions they raise can be overwhelming for the average person trying to make sense of the data.

Epidemiologists and an infectious disease expert who spoke with CTVNews.ca said it was too early to make predictions or draw conclusions from the data, but stressed the importance of understanding the context surrounding the numbers. 

While most of the focus has been on the daily tally of new cases, epidemiologists say that other data points are more useful.

Cynthia Carr, a Winnipeg-based epidemiologist with two decades of experience interpreting and developing protocols for gathering and analyzing health data, said the daily focus on new cases can be a distraction and spark unnecessary panic.

“[The public was] not listening to the information. They were in a store with 1,000 people at Costco buying toilet paper” when that was the last place they should be, said Carr.

The total number of tests administered, infections, hospitalizations, intensive care patients, and deaths are all key indicators for different reasons, explained Erin Strumpf, an epidemiologist and associate professor at McGill University.

“It’s more about the rate of change in those numbers than it is about the actual numbers on a given day,” she said.

The mortality and hospitalization rates – and whether they are increasing or decreasing over time – gives more context and balance to the data, Carr noted.

“You should never just look at one piece of information,” Carr said.

“I have said from the beginning, when we increase our testing capacity, you would quickly see an increase in cases… we’re getting more of an accurate denominator, an accurate representation of the number of people with the illness.” (CTV)