health

Thursday May 13, 2021

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Thursday May 13, 2021

On Doug Ford’s watch, a new health crisis looms

A soaring backlog of surgeries and medical tests is shaking Ontario’s health-care system to its core. And Doug Ford needs a second opinion on how to deal with it because nothing he’s done so far has worked.

April 1, 2021

In struggling with the crisis unleashed by COVID-19, the premier and his government have created a new one that could result in even more suffering and death than we’ve been witnessing. Simply put, people aren’t getting the care they need when they need it.

To be fair, Ontario’s health-care system had to implement major changes over the past year as it battled the pandemic. Public health officials had to redeploy finite resources — including doctors, nurses and hospital beds — so people who had fallen sick with COVID-19 could be treated. 

But three weeks ago, Dr. David Williams, Ontario’s chief medical officer of health, shifted course in a more worrisome way. He ordered hospitals across the province to halt all non-emergency surgeries and non-urgent procedures. That didn’t impact only people waiting for hip or knee surgery, it also affected people needing cancer and cardiac treatments.

Now, a rising chorus of doctors is warning Dr. Williams’ order is too restrictive. They insist the system could expeditiously treat more patients with serious medical conditions without weakening the fight against COVID-19. One of the people speaking out is Dr. Robert Nam, a Toronto surgeon who says he’s “had to turn away referrals to help patients with cancer because of the provincial order to cancel elective surgery.”

January 16, 2021

“For cancer patients waiting for treatment … their hopes of being able to beat their disease have been severely harmed by the stroke of a pen,” he added.

What makes the situation even more frustrating for Dr. Nam is that it doesn’t have to be this way. He argues hospitals have the capacity to deal with COVID-19 but also other illnesses because they’ve “developed efficiencies and surgical techniques for cancer operations that do not require a hospital bed.”

But it’s not just where the health system is today that’s alarming; it’s where the province is headed that demands immediate action. According to Ontario’s science table, the pandemic-related surgical backlog had grown to 257,000 cases as of April. As if that wasn’t bad enough, the province’s Financial Accountability Office now predicts wait-lists of 419,000 surgeries and 2.5 million diagnostic tests and procedures by the end of September.

July 27, 2019

As it stands today, people aren’t getting the timely MRI tests that might reveal a serious medical condition. And as many as 500,000 women have had their breast-cancer screening delayed. But while some of those women might have developed breast cancer, they’ll have to wait for it to be diagnosed, then treated.

Even if the health-care system can offer surgeries, tests and procedures well above pre-pandemic levels for an extended period of time, it will take the province three and a half years to clear this backlog, the Financial Accountability Office said.

Given such numbers, it’s hard to believe Health Minister Christine Elliott when she says the government is on top of this problem. While the last provincial budget committed $610 million to clear the projected surgery and diagnostic procedures backlog, the Financial Accountability Office estimates it will cost $1.3 billion to get the job done. 

Somewhere, this government must come up with $700 million to deal with the systemic backlogs that are increasing by the day. Somehow, it must find the staff and resources needed to confront two separate health-care crises. And somehow, it must learn to fight a health-care battle on two fronts and at the same time. (Hamilton Spectator Editorial) 

 

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) 

 

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)