November 02, 2009

You Can't Control Every Aspect; Plan Accordingly

Health Minister Leona Aglukkaq has blamed GlaxoSmithKline, the provinces and the public for the current issues surrounding the H1N1 roll out. Reality is, she doesn't have anyone to blame but herself and those involved in developing the plan.

We know that this plan has been in the works for months. Even as early as April Aglukkaq has been claiming the plan will be comprehensive and be as effective as possible in protecting Canadians. In August she restated this by claiming everything was ready and they were fully prepared for the virus. Presently, we know this not to be the case.

So what's wrong with the plan? It was based on assumptions, some based in reality though. But it didn't seem to consider common sense.

With traditional high risk groups, very young and elderly with underlying conditions, no one in the larger perspective bats an eye when a death occurs. However, it's well known that H1N1 targets groups that are not traditionally associated with the high risk and the flu. Groups such as healthy youth, young adults and pregnant women are vulnerable this time. Common sense would then tell us that if someone in one these groups were to die from the virus people are going to notice.

Common sense also would have told them that it was likely someone in the non-traditional groups would die. As it happens, several have died. And people noticed.

This is where we are at. While planning seemed to be based around polling, expected number of illnesses, production capacities etc., it didn't seem to plan for specific scenarios. This includes one that common sense should have alerted them to.

It doesn't matter how much (or in this case how little) you attempt to inform the public about giving certain groups will receive the first vaccine shots. And it especially doesn't matter that some polls said that as few as 30% of Canadians were even considering getting the vaccine. When someone like a 13-year old boy passes away even prior to the big roll out, people are going to panic and ignore whatever you told them. These people are going to flood clinics, worried that their child or themselves may be the next victim.

This whole issue also brings into question the judgment of Aglukkaq and et al to go with a single provider of the vaccine. It also brings into question their judgment to allow GSK to stop producing the adjuvanted vaccine for the non-adjuvanted version or to not have the non-adjuvanted version be produced elsewhere. Common sense would have would have should have told them otherwise, on all accounts.

If this government had only used their heads rather than seemingly relying solely on technocratic processes. Technocrats tend to live in a bubble, common sense exists and is grounded in reality. The H1N1 virus also operates in the real world and therefore the response needed to as well.

13 comments:

CK said...

Surely you've heard that vaccines have been supplied to private for profit clinics like Toronto's Medcan and Vancouver's Copeman Health.

If you want to sign the petition to not allow expansion of private for profit in Canada; particularly in the distribution of the vaccine: Copy and paste (sorry, can't figure out how to do HTML on comments).
http://medicare.ca/mr-nov02-2009

As for Agluquack (I have even more gross name for her, but won't use it) and Butler-Jones, the two should resign; this is a disgrace.

Prairie Kid said...

How quick people forget about SARS. The Liberal government was unable to anticipate the severity of SARS. You can't plan for mass hysteria whether it's warranted or not. So for you to blame the Conservatives for this you need to look at your own party and it's handling of the SARS epidemic.

Kyle said...

CK,

I agree that this can't be overlooked and if that means Aglukkaq needs to be canned along with others, then so be it. As for the private health care clinics receiving the vaccine, that too should be looked at as there is no justification for them getting any of the vaccine that was specifically produced for public use.

Kyle said...

Prairie Kid,

Please. SARS has absolutely nothing to do with this incident. It's irrelevant really. Your bringing it up only does two things (neither of which are flattering for your side):

1) bringing up SARS as a response to a criticism on H1N1 implies that you don't actually have a response; and

2) if SARS is an comparable example, then why didn't the Conservatives look at how it was handled and again, PLAN ACCORDINGLY. There's an old adage about learning from the mistakes of others somewhere...

Big Winnie said...

Aglukkaq, like most CONs won't take responsibility for the government's failure. Here are my reasons:

1) One supplier: This is a single point of failure. Why not have 2 or more, incase, one needs to shut down?

2) Tying into point 1), had they had a 2nd supplier, the one could have finished producing the seasonal flu vaccine and then worked on the unadjuvanted vaccine without affecting the production levels of the adjuvanted vaccine.

3) Communication to the public was sorely lacking. How else would you explain the volume of calls and downloads. Had their been a comunications plan, the call/download volumes wouldn't be so high.

4) I've heard, and am still looking for confirmation, that there was the possibility of a shortage of the vaccination and this was reported to the WHO in August. If this is the case, why didn't the government revise it's estimates, and also look for another supplier?

BTW, what does SARS have to do with H1N1?

tjeerd said...

We are doing very well with H1N1.

Liberal Messiah south of the border is less then half our rate in getting the vaccine out.

Axelrod admits
"we over promised"

http://www.npr.org/templates/story/story.php?storyId=114351010&ps=cprs

Nothing on Huffington regarding Obama H1N1 shortage.
Why should I be surprised, Sarah Palins wardrobe trumps Obama incompetence on that blog.

CanadianSense said...

Can you post the quotes she is blaming anyone?

I have watched the media and opposition trying to find a scapegoat and create hysteria over this.

How many died in Canada from Sars and worldwide > 44,800.

The truth and the numbers can kill a good crisis and kill tv ratings.

I don't expect the media or the opposition to be truthful or fair in reporting the numbers and the mortality rate from H1N1.

AU just went through H1N1 wave II we can use extraplote the numbers. Are we going to do better, same, worse?

http://www.montrealgazette.com/health/HealthWatch+H1N1+vaccine+just+shot+dark/2173987/story.html

How serious and widespread is H1N1?

H1N1 has been declared a pandemic by the World Health Organization, the first one of the 21st century. WHO reports that nearly 5,000 people worldwide have died this year as a result of H1N1; as of Oct. 26, this includes 86 Canadians. Patients who experience life-threatening complications do so as a result of lung problems that require them to be placed on respirators. The Australian experience this past summer revealed that 29 out of every million in the population got so sick from H1N1 as to have ended up in an intensive care unit and 15 per cent of these died. Extrapolating to the seven million inhabitants of Quebec, we might expect about 200 patients requiring intensive care and 30 deaths. This is just a guess, however, and the tendency for flu to spread more rapidly as we stay indoors over the winter months may make this worse if we don’t fight back with vaccine. Australia did not have access to the vaccine this summer.
http://en.wikipedia.org/wiki/2009_flu_pandemic_in_Australia

CanadianSense said...

Most of the earlier posting the Federal gov't is responsible can you provide any proof the supply is gone?

How does six million doses get used in 8 days?

How is your math? I have only heard of news reports that hundreds of thousands have had their shots.

Anyone in defence of the Liberal Party or News media suggesting 6 million Canadians have been vaccinated? Really?

If we have not burned through 1 million, where are the 5 million?

So if Supply is not the issue what is the hype about a reduction for a line change for alternate production run?

The Plan was rolled out 9 days now. How many nurses doctors, staff, official needle jabbers does it take to burn through 1 million doses?

Some of you people are easily misled.

CK said...

Canadian Sense: Can you post the quotes she is blaming anyone?


Watch yesterday's Question Period: you'll get enough quotes:

http://watch.ctv.ca/news/ctvs-question-period/june-21-2009/#clip230111

CanadianSense said...

CK I have those on my blog and watched Fife and Taber repeated try to get her to blame someone.

Fife asked her loaded questions?
Did she take the bait or give her standard answer?

(Politicians follow the script, I have heard that 100x from her now)

She did not suggest we ran out of the vaccine did she? Did she remind Taber Fife 6 million were shipped?

She was interrupted by Taber repeatedly when she refused to blame someone.

Do you think it makes political sense to blame the provinces for the Federal Government?

We don't have a supply issue the Fed negotiated an agreement (recommendation) with the provinces and territories.

The provinces and territories than ship it to the local health organizations. (Still with me?)

Have we used up the "supply" in 9 days?

Next week only 400k than back up to 1-3 million per week.

So explain the supply issue again, did we burn through 1,2,3 million, all six?

Why can't the media do simple math?

wilson said...

Each year regular seasonal flu causes 4000-8000 deaths in Canada.

H1N1 has caused 97 deaths this year, in Canada, as of today.
Experts say we have hit the peak mid October.

1. There is NO vaccine shortage.
No Province has run out of vaccine.
As Don Martin points out:
'Alberta received almost 700,000 doses but closed its clinics over the weekend after injecting 400,000 vaccines.
Ontario claims to have done "hundreds of thousands" yet it received over 2.3 million doses.'

2. The Feds sent out a guideline of high risk, first recipients
on September 16, the provinces did not follow the guidelines.

http://www.phac-aspc.gc.ca/media/nr-rp/2009/2009_0916-eng.php

3. The uptake on the vaccine was slow, so the feds and provinces implored people to get the shot.
Then 2 healthy kids died, and the panic began.

Health units did not have the STAFF to deal with the frantic lineups, they did and still do have the vaccine.

Neil said...

The public is confused because there are ten provinces with ten different health care systems. Within each health care system there are hundreds of health regions, each rolling out the vaccine differently. There has been no universal rollout and that is what is confusing Canadians, PERIOD. The federal government SHOULD have ordered the vaccine in June or July and they SHOULD have cancelled orders for the seasonal flu vaccine, but in terms of the rollout, that is the responsibility of the provinces, not the feds. Canadians are confused because they're getting mixed messages from hundreds of health regions across the country. Moreover, if the public is to blame, it's because the public panicked when an otherwise healthy child died of H1N1 last week. That scared the shit out of people. That said, you have to be a complete MORON if you don't understand the signs at every vaccination site across the country which CLEARLY SPELLS OUT who is eligible for the vaccine. Those huge lineups we're seeing on the news are made up in large part by people who are que jumping or NOT on the targetted groups list. What part of WAIT YOUR FREAKING TURN aren't people getting?

Kyle said...

SARS and what the Liberals allegedly did or didn't do, 5 years ago or 8 years ago, etc. are all irrelevant to this discussion except on one point: any problems that were exposed back then should have been used to inform the H1N1 planning. Apparently it wasn't and that is the responsibility of Aglukkaq and her colleagues.

If there are problems in the US, then someone needs to take responsibility for it, likely the planners. Maybe they made similar mistakes to that of Aglukkaq. But to think that since Obama's administration made errors absolves Aglukkaq of any responsibility you're mistaken.

As for where Aglukkaq blames others, you only need to watch yesterday's question period from within the House. She clearly blames others when responding to another MP's question. Also watch QP and other interviews from late last week and you'll find her blaming others there as well. Check the Ottawa Sun, the Truro Daily.

It comes down to this, the planning (vaccine production, quotas, initial and phased roll out, dissemination of information, dissemination of vaccine to the provinces) was the federal government's job in full or in part. Too many mistakes were made here - not enough common sense, not enough educated steps - and it all goes back to the Minister of Health and her colleagues.

Quotes from people smarter than me...

"If a free society cannot help the many who are poor, it cannot save the few who are rich" ~ JFK

"Our lives begin to end the day we become silent about things that matter. " ~ Martin Luther King Jr.

"Those who would give up essential liberty to purchase a little temporary safety deserve neither liberty nor safety. " ~ Benjamin Franklin

"First it is necessary to stand on your own two feet. But the minute a man finds himself in that position, the next thing he should do is reach out his arms. " ~ Kristin Hunter

"When you're a mayor and you have a problem you blame the provincial government. If you are provincial government and you have a problem you blame the federal government. We don't blame the Queen any more, so once in a while we might blame the Americans." ~ Jean Chretien

"Which is ideology? Which not? You shall know them by their assertion of truth, their contempt for considered reflection, and their fear of debate." ~ John Ralston Saul

"It is undoubtedly easier to believe in absolutes, follow blindly, mouth received wisdom. But that is self-betrayal." ~ John Ralston Saul

"Everybody dies, Tracey. Someone's carrying a bullet for you right now, doesn't even know it. The trick is to die of old age before it finds you." ~ Cpt. Malcolm Reynolds (Firefly, Episode 12)

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