public health – mackaycartoons

Wednesday October 28, 2020

November 4, 2020 by Graeme MacKay

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Wednesday October 28, 2020

Are politics trumping public health in Halton?

Are elected leaders in Halton Region at odds with regional public health officials over the best way to combat the alarming spread of COVID-19?

October 14, 2020

That is certainly one interpretation of events of last week and early this week that culminated with the Ford government’s decision Monday not to roll back reopening to a modified Stage 2 in Halton.

We are not arguing that decision was right or wrong. We are not experts. But until this week, those experts were sounding the alarm over the spread of the virus. And the province said clearly that Halton was among the regions where the spread of COVID-19 was considered serious enough to warrant rolling back reopening.

Then the mayors of Burlington and Milton, Marianne Meed Ward and Gordon Krantz, Regional Chair Gary Carr and MPPs Jane McKenna and Parm Gill wrote a letter to Chief Medical Officer of Health Dr. David Williams, in which they publicly disagreed with their own medical officer of health. They wrote: “Even with our numbers continuing to decline, we understand that Halton’s medical officer of health is pushing to move Halton Region back to Phase 2 … in line with Peel, Toronto, York and Ottawa.” A similar letter was written to Premier Doug Ford.

The politicians made a compelling case for not rolling the region back, but instead adopting a more targeted approach. And the province listened. Halton will not be rolling back, at least not yet.

No doubt many businesspeople and citizens are pleased. But this raises some troubling questions.

June 3, 2020

How is it that these politicians know more than their top public health expert? What does that say about the relationship between them? Why did the politicians go over the head of public health officials to the premier’s office? Do Halton’s top elected officials not have confidence in their senior public health officer? Why are two members of Doug Ford’s own caucus going against the advice of regional health officials?

And most importantly, what are Halton citizens, who look to their elected leaders and public health officials for leadership, to make of all this?

Asked about the situation by The Spectator’s Joanna Frketich at a media briefing, Hamilton Mayor Fred Eisenberger sounded critical of the Halton politicians. He stressed that he takes his guidance from public health, and would not be moved by other considerations. You can agree or disagree with that (we agree), but at least it’s clear. In Halton Region, that is less so, and that’s not good.

The Halton leaders were clear about one thing: They want the province to provide clear, consistent metrics on how and why decisions are made about reopening and rollbacks. That’s reasonable, and they are not the first to call for more transparency.

Addressing the situation, Ford said he was the one who recommended the politicians write a letter. Then he spoke about how input from local political leaders is important. Then he said such letters are not considered in the eventual decision. Thanks for the clarity.

Ford is said to take his guidance from a table of health experts. But the public doesn’t even know who sits at that table, never mind what specific measures they consider before making recommendations to the premier.

As the pandemic drags on, situations like this one are bound to become more common, causing confusion and uncertainty. The government must provide a new level of clarity and transparency about data, priorities and decision-making. When citizens see and understand the evidence behind pandemic decisions, they are more likely to comply. The government should keep in mind the reverse is also true. (Hamilton Spectator Editorial)

Thursday October 8, 2020

October 15, 2020 by Graeme MacKay

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Thursday October 8, 2020

Ontario’s conflicting public health messages are dangerous

May 29, 2020

If Premier Doug Ford’s objective is to sow confusion and uncertainty about Thanksgiving and this pandemic, this week he is succeeding spectacularly.

On Tuesday, Ford spoke at a COVID-19 news briefing, and sounded positively muddled.

“Please, this is very simple,” he said. “There’s rules and there’s guidelines. The rules are very clear. Ten indoors, 25 outdoors. I would really, really discourage people from having 25 people, even if it’s outdoors. Stick within 10 people. And folks, we went through so much together. And we can get through this.”

Clear as mud? Now add to the mix that public health authorities, including Ontario’s Associate Medical Officer of Health Dr. Barbara Yaffe and Toronto Medical Officer of Health Dr. Eileen de Villa are urging people to celebrate Thanksgiving only with members of their immediate household.

Here’s de Villa: “Please do not hold a big Thanksgiving dinner. Please limit your Thanksgiving dinner to the people you live with. I would far rather that we change Thanksgiving one time for safety sake then look back at Thanksgiving 2020 with enormous regret.”

September 26, 2020

Now back to Ford: “Thanksgiving is going to make or break it. Just please hang in there. You know, I have a big family and I told Karla (Ford’s wife), and she knows this, we can have no more than 10. Simple as that.”

These conflicting messages are a lot of things, but simple they are not.

For the record, the official advice at this point is to mark Thanksgiving only with people in your immediate household. Anyone outside that should connect virtually, not in person. Ford has now revised his position and agrees with that.

Aside from anything else, these duelling positions point out an alarming and widening gulf between what public health experts think should be happening and what the government is willing to do. Toronto’s de Villa wants indoor dining and bars in that city shut down for 28 days, but Ford says the data doesn’t warrant doing that.

July 17, 2020

The Ontario Hospital Association is warning that the health system could quickly become overwhelmed by the second wave. Anthony Dale, the association’s CEO says: “There is enormous growing risk. To keep hospitals functioning like they are now, rolling on all cylinders, we need to stop the community spread of COVID-19. Much more effective public health measures are needed.”

It is fair to note that the government needs to worry about the entire picture, not just the public health aspect. The economic and social impact of even localized lockdowns, like what de Villa is proposing for Toronto and others are suggesting for all hot spots, would be huge. Many businesses, especially in the hospitality sector, have said they cannot survive another lockdown.

But consider this: Ford also said this week that Ontario is flattening the curve. Numerous health experts disagree. University of Toronto epidemiologist Dr. David Fisman says: “There is no indication we are flattening the curve, and indeed hospitalizations are up sharply over the past two weeks, as the premier should know.”

If the government is acting on advice that suggests we are flattening the curve, but more and more health experts say that is not the case, there is a real danger that Ford’s reluctance to do more could be contrary to the public interest. The results of that disconnect could be tragic. (Hamilton Spectator Editorial)

Friday June 5, 2020

June 12, 2020 by Graeme MacKay

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Friday June 5, 2020

We should have done more, admits architect of Sweden’s Covid-19 strategy

Sweden’s chief epidemiologist and the architect of its light-touch approach to the coronavirus has acknowledged that the country has had too many deaths from Covid-19 and should have done more to curb the spread of the virus.

May 6, 2020

Anders Tegnell, who has previously criticised other countries’ strict lockdowns as not sustainable in the long run, told Swedish Radio on Wednesday that there was “quite obviously a potential for improvement in what we have done” in Sweden.

Asked whether too many people in Sweden had died, he replied: “Yes, absolutely,” adding that the country would “have to consider in the future whether there was a way of preventing” such a high toll.

Sweden’s death rate per capita was the highest in the world over the seven days to 2 June, figures suggest. This week the government bowed to mounting opposition pressure and promised to set up a commission to look into its Covid-19 strategy.

“If we were to encounter the same disease again knowing exactly what we know about it today, I think we would settle on doing something in between what Sweden did and what the rest of the world has done,” Tegnell said. It would be “good to know exactly what to shut down to curb the spread of infection better”, he added.

In an interview with the Dagens Nyheter daily, Tegnell subsequently said he still believed “the basic strategy has worked well. I do not see what we would have done completely differently … Based on the knowledge we had then, we feel we made the appropriate decisions.”

According to the scientific online publication Ourworldindata.com, the number of Covid-19 deaths per capita in Sweden was the highest in the world in a rolling seven-day average to 2 June. The country’s rate of 5.29 deaths per million inhabitants a day was well above the UK’s 4.48.

The Swedish prime minister, Stefan Löfven, told the Aftonbladet daily that the country’s overall approach “has been right”, but it had failed to protect care homes where half of all Sweden’s Covid-19 deaths have occurred. Social affairs minister Lena Hallengren told Reuters the government had been “at all times prepared to introduce wider, further measures recommended by the expert authority”.

Life in a Pandemic

Relying on its citizens’ sense of civic duty, Sweden closed schools for all over-16s and banned gatherings of more than 50, but only asked – rather than ordered – people to avoid non-essential travel and not to go out if they were elderly or ill. Shops, restaurants and gyms have remained open.

Although there are signs that public opinion is starting to shift, polls have shown a considerable majority of Swedes support and have generally complied with the government’s less coercive strategy, which is in stark contrast to the mandatory lockdowns imposed by many countries, including Sweden’s Nordic neighbours.

But the policy, which Tegnell has said was aimed not at achieving herd immunity but at slowing the spread of the virus enough for health services to cope, has been increasingly and heavily criticised by many Swedish experts as the country’s death toll has increased.

Sweden’s 4,468 fatalities from Covid-19 represent a death toll of 449 per million inhabitants, compared with 45 in Norway, 100 in Denmark and 58 in Finland. Its per-million tally remains lower than the corresponding figures of 555, 581 and 593 in Italy, Spain and the UK respectively. (The Guardian)

Wednesday December 6, 2017

December 5, 2017 by Graeme MacKay

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Wednesday December 6, 2017

Supervised injection site in works for downtown Hamilton

The city has endorsed a supervised injection site for downtown Hamilton but it’s up to a community agency to step up to run such a facility.

The city’s board of health endorsed the findings of a long-awaited study Monday that recommend adding at least one permanent site in the core for people to safely inject illegal drugs under the watchful eye of health professionals.

But the study also recommended the site be “integrated” with an existing agency that already offers “harm reduction” services, like needle exchanges or addiction treatment.

Hamilton’s public health unit will offer “in-kind” support for a supervised injection site, said medical officer of health Dr. Elizabeth Richardson, but she added it is expected the province will fund operations by a willing community agency.

Richardson said unspecified agencies in the downtown area have “informally expressed interest,” but added it may take several months before an application is completed and vetted by the government. (The province is expected to pay for operations, but the federal government also has to give an exemption for illegal drug use and possession on site.)

She wouldn’t speculate about which agencies will apply to run a supervised injection site, but two groups that already offer related services showed up Monday to urge city support.

Wesley Urban Ministries already runs a supervised consumption site for residents battling alcohol dependency, offers “harm reduction materials” for drug users and sexual health counselling, noted housing and homelessness director Dean Waterfield.

“We know practising harm reduction leads to further treatment, better health care and better neighbourhoods,” said Waterfield, who added 10 agency clients have died by drug overdose this year. He urged councillors to add a supervised injection site “to the tool box” of local agencies. (Source: Hamilton Spectator)

Tuesday April 26, 2016

April 25, 2016 by Graeme MacKay

Editorial Cartoon by Graeme MacKay, The Hamilton Spectator – Tuesday April 26, 2016

Ticks that spread Lyme disease are in Hamilton, warns study

Ticks that spread Lyme disease are in Hamilton warns a study accusing the public health department of “under-reporting” the danger and giving “the false impression” acquiring the illness here is unlikely.

“Lyme disease-carrying black-legged ticks pose a public health risk in the Dundas area and the surrounding Hamilton-Wentworth region,” concludes the research by Lyme Ontario published in the International Journal of Medical Sciences.

A Lyme Ontario researcher found 41 per cent of black-legged ticks collected in Dundas over two years were infected with Borrelia burgdorferi — the bacteria that causes the disease.

The results are in stark contrast to a report by Hamilton Public Health Services finding no infected ticks during a five-year period in an area 20 times the size, states the study.

“We point out the difference between what the health unit is saying and what we found out in the field,” said lead researcher John Scott. “There is a notable difference … of over 600 times. I would say their surveillance program isn’t working.”

The study calls for tick and Lyme disease warning signs, deer management strategies and advisories to health-care providers.

“Public Health Services appreciates the work of local researchers with respect to black-legged ticks in Dundas,” said Dr. Jessica Hopkins, an associate medical officer of health, in a statement. “We have just become aware of the recent publication and are in the process of understanding the study and its implications.”

Hamilton is not listed as a Lyme disease risk area by Public Health Ontario.

Local doctors and hospitals were told “Hamilton is not an endemic area and acquiring Lyme disease in the Hamilton area is unlikely” in a medical advisory from the city’s public health department in August 2013 — the same time the Lyme Ontario researchers were finding infected ticks.

“They are downplaying the health risks in this area,” said Stoney Creek Lyme patient Nancy Diklic. “I believe I was bit locally going on 11 years ago. To this day, the local public health unit says Hamilton is not an endemic area.”

She wants proper warnings so residents can take precautions such as covering exposed skin, using insect repellents, doing full bodychecks for ticks, showering within two hours of being outdoors and removing ticks within 24 to 36 hours. (Source: Hamilton Spectator)