While I'm not a proponent of anything conspiratorial, I am a proponent of competence and logic. Not speaking for what is going on in other countries or even how the pandemic response and vaccination is being handled by other provinces here, I can say that I'm deeply unimpressed and disappointed with how Ontario has dealt with all of this.
There are four levels of Government wrapped up in this and, despite working for one of those levels (not in Health), and despite the fact that's it's a fallacy that "governments can't get ANYTHING right", it sure is pushing credulity to expect that FOUR LEVELS of jurisdiction won't screw things up horribly. Sadly, this is being proven out ... even here.
Federal, Provincial, Regional and Municipal governments all, of course, have a role to play. Each has its mandate and each is freakishly sensitive to not overstepping their own bounds into someone else's. It's not responsibility avoidance, it's legislated boundaries. So, the real problem becomes one of communication and cooperation. Ok - that doesn't need any further exploration, does it?
Theoretically, the framework *should* work. Fed's set overall policy and regulatory approvals. Provincial authority sets acquisition, distribution, communication and triage/priority. Regional authority is supposed to be a kind of coordinating/negotiating body between the Province and the Municipalities and between the Municipalities themselves. The regionals also set up regional clinics (as they do every year for the seasonal flu). Finally, inoculation delivery is the responsibility of the Municipalities.
You'd hope with that sort of top-down flow that everything should progress smoothly.
Well. Harumph. Not freaking hardly.
The feds keep on changing their minds about pregnant women and adjuvanted and non-adjuvanted. And now between one-dose for kids 3 - 9 or two doses. Now the supply is being held up, partially because the feds made the not unwise "err on the side of caution" decision to change horses midstream and go from all vaccines being adjuvanted to a supply of non-adj for pregnant women.
So the province is scrambling to secure, distribute, approve and test supplies - as well as set up their own provincial vaccination clinics.
There have also been confused communications around the why's and wherefores of getting the vaccine. "It's HORRIBLE", "It's mild", "It's HIGHLY contagious", "It's no different than seasonal flu", "It's attacking young people, under 20 - with the most hospitalizations occurring with girls, ages 10 - 14", "People 'most at risk' are being inoculated first - pregnant women, children between 6 months and 5 years and people under 65 with chronic conditions", "the Vaccine is safe and tested", "we will continue to monitor, because it is so new". I mean, really ... don't they ever just put everything on a single "reel" and play it all from end-to-end?
I'll even accept that contextually, all of the above statements might be true. They've done a suck-*ss job in rationalizing the confusion and addressing the real concerns.
1) Is it safe? Why? On a case and point basis.
2) Why are you continuing to "test". (Obviously because they keep on monitoring for all vaccine's as a matter of course, but they need to articulate that).
3) What are the societal risks of a very high infection rate, even with a low mortality rate?
4) Compare and demonstrate - SIDE BY SIDE and YEAR over YEAR, the seasonal flu infection, spread and mortality rates compared to (a) the Spanish Flu of 1919 and (b) H1N1A.
5) Acknowledge the limitations of the statistics - reporting, testing (both current and historical), including the methodologies and the rationale behind same. Discuss how comparing different era's is a challenge.
6) What are the risks of the death rate/100k increasing dramatically beyond what it has been to-date? Why or how might this happen? How will the chances of this occurring be mitigated by mass inoculations? What's the implication of under-inoculation on the likelihood of increased virulence?
7) How on earth do they plan on inoculating, say, 2.5M people (roughly half of Toronto, including the close urban sprawl) in a rationally timely fashion?
8) What is the effect of the program if it's not delivered until mid flu season? Late flu season? Factor in the period needed for the antibodies to provide immunity.
9) How long, after inoculation, does it take for immunity to kick in? What happens in the "ramping up" gap between inoculation and immunity? Is there partial protection? Is one's immune system more vulnerable since it is busy producing antibodies as a result of the inoculation? How long is the period of extra-normal vulnerability? Is the vulnerability the same as when you are fighting off a cold? Worse? Less?
10) What happens if you are already infected when you get the inoculation? Are there any risks from taxing the anti-body production centres while you are trying to fight off the virus itself?
11) What are the challenges in delivering the vaccine? Is there a shelf life? How long? Does it require mixing of two parts? Does the mixing require a Doctor? Why? Why not a pharmacist of a nurse? What are the risks if it is improperly mixed? Why is it not being delivered through the schools - as other programs have successfully done?
That's just pretty much a "partial" list. But *all* of those questions (and perhaps more) need to be answered (a) in one place and (b) in RELATION TO ONE ANOTHER.
If there are challenges to testing, delivering, mixing, injecting the vaccine, I suggest that we would all be better served if they just explained clearly what the issues are. Yeah, maybe it makes them look bad, but really, people don't look nearly as bad from having to grapple with rational challenges than they do from keeping quiet and screwing things up.
Oh ... and to support the rant:
http://www.cbc.ca/canada/montreal/st...ekos-poll.html
Ya know ... it's pretty clear to me that there is a far higher incidence of illness and absenteeism. Surely a certain amount can be written off to "panic", over-cautiousness or even rational prudence. Even so, flu-like symptoms are almost certainly driving a lot of the absenteeism. It's difficult as a lay person to know, judging from the virtually indistinguishable-from-seasonal-flu symptoms, exactly when to hit the "I'm sick" button. I've heard from plenty of people at work about spouses/family that have been seriously/gravely ill this year ... far worse than season's prior.
In some areas, the health system is getting overrun:
http://www.cbc.ca/canada/nova-scotia...ick-notes.html
... and for those of you who would want to make an argument that PRIVATE health care wouldn't be overrun because people would be more reluctant to go to a doctor because of a "mere sniffle", I'd suggest (a) safety is the wiser side of caution, (b) if people really ARE sick, or are truly at-panic, the private system would be just as overrun as a public one - except their would be a ton-o-profits being made. In fact, you'd think it's in the interest (profit motive) of private enterprise - clinicians and pharma alike - to PUSH the vaccine (see: "Baxter" and BIGPHARMA)while AGAINST the interests (cost and resource controls) of public interests.
None-the-less, this all should have been handled so so SO much better. I guess this is why having large planning exercises has huge value. It's why the military does it. It's why businesses do it. Maybe this will turn out just to have been a massive, practical pandemic identification, control, mitigation and response exercise. I will buy into THAT as having value as long as there are serious lessons-learned and that they are applied.
So there. Rant over.
