Time for H1N1 Leadership. A shared responsibility.
Saturday, October 31, 2009 at 11:51AM We respect our elders, mostly, and that is a good thing. Especially since as a parent, I hope to maintain some semblance of hierarchal order in society. I want the system to hold-up at least long enough until I can get a discount on my breakfast, or free coffee refills at my neighbourhood fast-food restaurant.
So the recent H1N1 vaccine has us turned on our heads a bit. The pandemic, if it is that, is picking up steam and spreading faster than the public is able to consume the information required to help us defend against it. What I mean by that is that I think our FRONTLINE healthcare system is doing an admiral job in spreading information, promoting best practice, and trying to allocate the available vaccine to those at risk.
But there are two segments of the population I think need to take more accountability in managing the hype and panic spreading across our region. Government and Healthcare leadership and those of use who are not considered a great risk for contacting and being harmed by the virus.
The concept of free access to healthcare does not equal the public’s feeling of entitlement to its unmanaged distribution. We must consider that like all complex issues, there needs to be a complex management of said issue. According to the Alberta Health website, these are the people who should be prioritized to receive the vaccination:
- People under 65 with chronic health conditions;
- Pregnant women;
- Children six months to less than five years of age;
- People living in remote and isolated settings or communities;
- Health care workers involved in pandemic response or the delivery of essential health care services; and
- Individuals in households and care providers of persons who cannot be immunized or may not respond to vaccines.
My guess is that there are thousands of Albertans who fall outside of these categories, blocking the effective delivery to the at-risk communities. So if that was the case, then there are three things that should be done immediately to manage the risk.
1) If you are not at risk, get out of the line. We all would have a hard time trying to tell a respected, healthy senior, to get out of a line-up. But they need to be told and I think we underestimate them as practical citizens who understand complex issues. The next point talks to who should be telling them.
2) We need our government and healthcare officials to get in front of the same media that is spreading the hype, and be bold enough to say it as it is. Where are our Premier, MLA’s, Mayors and healthcare management? Now is the time to forget scripted press releases and appear on radio stations, television, newspapers and the social media spaces, imploring low-risk Albertans to stay home and make room for those above mentioned communities. Not in a week, but NOW.
3) Once these two things are done, the third would come easy. That is give our frontline workers the authority to refuse service to those who are clearly not at risk.
If we were all standing on a sinking ship, I hope we would still subscribe to the Women and Children first honour code. Let’s see some of that, knowing what we know about this virus, and get help fastest to those who need it.
Don’t get me started on the political upside available to our Premier if he started to apply his authority on this issue. He is largely accepted as a pragmatic and trusted individual. Now more than ever he should be exerting his reputation to the benefit of his Province. I know that this is not a time for politics, but is it fair to say that it is a time for leadership, and his will be tested in a week?
UPDATE - October 31st, 5:30pm_____________________________________________
Tonight Alberta Health Services announced that they are suspending all H1N1 Clinics until early next week, and upon re-opening will be addressing the needs of the most at risk, including:
- pregnant women,
- children aged six months to five years,
- and those under 55 with chronic health conditions.
iNews880 coverage with Audio of the press release here.
Edmonton Journal coverage here.
So, since it looks like I have gotten my wish, I should recognize that the Government and AHS are at least making the best of a bad situation. There are many great points to be debated, and in particular the lack of planning that went into this in the first place, but I will leave that to the pundits.
If this was a strictly political decision by our Premier Ed Stelmach ater reading this blog post, and assuming that he is in a reflective mood, perhaps Ed can call me and schedule a lunch. I would LOVE to talk with him about Bill 44.
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Reader Comments (6)
Leaders being accountable is corporate suicide. A happy voter is a consumer that is believing they're being looked after for their tax.
What's happening is filtering, or political geneocide. If you take away hope you have control over the majority voice. If someone steps out of line, you make an example of them, lock them up. You know we are in trouble when our jails become privatized, like what happened in the States, during the Reagan years.
Are we already past that point? I'm really not sure. I know the new remand centre off of 127st looks like an immense construction project. What happens when it's done and the workers are knocking on WCB's door?
Is that irononic or synical?
BTW - did you know... 75% off the incarcerations in the US are petty drug possession related charges?
Hear hear! Well said. People should really be able to manage their fears better though and assess themselves properly.
Thanks for an excellent post. The spin justifying the set up for delivering the vaccinations using the free-for-all system is that 300,000 people were vaccinated so quickly. I didn't realize there was a contest. What did we win?
Thanks for your post Chris. This process does require citizen participation. Those at higher risk should be allowed to go first. Should the process have refused to vaccinate those outside the risk parameters? That is not a judgment call that is easy to put on a frontline worker facing thousands with little time for assessment. How do you require proof of chronic or underlying health condition. With a significant expectation of continuing and constant supply of vaccine it made more sense to have the most efficient delivery with centralized high performing clinics and call on the public to go only if they qualify. There is always the risk of running out for short periods of time - but population immunity means we have to immunize as many people as possible. Therein lies the balance between encouraging people to take it seriously and go for the shot with asking them to let those with the highest need go first.
Dave:
Thank you for the comments. As I stated in the post, I consider this a very complex situation, and it's obvious that it also a very fluid one with vaccine inventories, unknown public response, etc. all at play.
If you read it though, I am really imploring people who shouldn't be there to stay away, and our leadership to get in front of every possible media to help that along. In situations like this, I honestly believe that the Premier should be the spokesperson for this type of message. Minister Liepert was a horrible spokeperson with his blunt, condescending and flip-flopping approach.
Premier Stelmach is different, and has credibility with Albertans as "Honest Ed". What could have been achieved if he had stood in front that news conference WITH Dr. Preddy, saying something like this:
"We are firstly very proud of our frontline workers who are trying to deal with a response that is 10 times what we expected. So if I can ask all Albertans a favour, and only for a few days. Please only come out for the vaccine if you fall into one of the at risk categories. We had hoped that all Albertans could get immediate access to the vaccine, but we screwed-up in estimating just how many would respond. If you are standing in one of those lines, and are not in an at-risk group, you should first be questioning why you are taking the spot away from an at-risk Albertan, but also you should expect to be turned away by our staff if you clearly do not qualify."
Then I would bring down a heavy fist on Minister Liepert who has even stated that he hadn't read the 40-page report Alberta Health Services.
I know that this is complicated, but trusting advisers and senior bureaucrats 100% of the time, and delegating the messaging to them, is also not a good idea. Sometimes a leader has to step outside the fray and take charge, say sorry, and point the ship in the right direction.
Good points Chris. It is my understanding that other provinces have restricted the vaccine to high risk groups only to date.
Consider this: Why is the government health care system permitted a monopoly on this vaccine? If I want to pay out of pocket and buy vaccine for myself and my family why can't I do that? Why is it that your physician and pharmacist don't have access to it yet? The drug suppliers say they have enough stock, so in a truly free market we should be able to just purchase the vaccine and inject ourselves. We should not require government permission to control our own health care management.