Showing posts with label public health. Show all posts
Showing posts with label public health. Show all posts

2023-02-27

COVID-19 Pandemic Reflections and The Next Pandemic

Well the pandemic is over, at least according to most governments, science and medicine not so much. So now it is time to look back, and to look forward.

Perhaps my biggest reflection is that governments, at least in Canada, did not receive the rational criticism for their failures that they should have. The media was intent on concentrating on the irrational response of the anti-science, anti-public health, anti-vaxer crew who were co-opted by the far right white supremacist convoy types in Canada. The left, on the other hand, felt so strongly the need to defend the principle of governments acting to protect Canadians from this deadly pandemic that they failed to properly criticize governments failures in doing so. Not that there was no rational criticism, but what there was was overwhelmed by the Freedumb Convoy Shitshow.

The biggest failure was in not being prepared, even though scientists and public health officials had predicted that pandemics would be commonplace in the future, along with not following the precautionary principle and treating it as airborne until that could be completely ruled out.

But the most egregious, and I would say unforgivable decision, was to not utilize the front line of our health care system, but rather shutting down the vast majority of family physicians’ offices pushing an even greater workload onto the overwhelmed hospital system. This was either complete negligence on the part of the health care system or a clear indication we don’t actually have a health care system but just a bunch of disconnected parts.

As far as messaging goes, we had the use of the language “social distancing” rather than “physical distancing” at a time when maintaining social connections was critical to people’s mental health. Along with that error in messaging was the message to stay inside, rather than stay away from other people, at a time when getting outdoors (with appropriate precautions) could be critical people’s mental health.

However, in the long run, if only coincidental, there is some truth to the arguments for “no more lockdowns” and “we have to learn to live with the pandemic”.

If and when pandemics become a normal part of our reality we will indeed have to learn to live with them and it will not be sustainable to completely shut down our economy and society everytime they occur. Shutdowns or lockdowns, whatever you want to call them, will have to only occur rarely and for short periods when necessary to get an initial grasp of what is happening. And they will of necessity have to be political decisions.

But living with pandemics does not mean ignoring them. It means taking necessary precautions, such as physical distancing, masking with high quality masks, extensive vaccination programs, and, at times, restricting the highest risk activities such as large indoor gatherings of people packed closely together for long periods, methods that have been proven to work and reduce the incidence and seriousness of the outbreaks and most of all save lives.

But most importantly it means being prepared beforehand.

The first step in being prepared is having a primary care system where everyone has access to a primary care physician. In Ontario everyone does not have access to a primary care physician so we urgently need to drain more family doctors, fast track the approval of foreign trained doctors to work in Ontario and increase immigration and training of doctors from abroad, along with increasing the number of nurse practitioners available. And, of course, not shutting the primary care system down during a public health emergency.

We also need to have a hospital system that is not running at over 100% of capacity during the best of times. How do we build in excess capacity without it being inefficient. By using that excess capacity. As it is now so-called elective surgery is ridiculously backlogged. But this elective surgery is not elective at all. What we call elective surgery is surgery for non-life threatening conditions. Knee and hip replacements, eye surgery and many other so called elective surgeries may not be life saving but they certainly can be life changing for many patients for whom they make life worth living again. We can then, in the case of a public health emergency, divert that capacity to save more lives during a future pandemic. Purpose built publicly funded and operated specialty clinics can be part of that solution, and can be used to treat pandemic patients separate from hospitals, reducing the risk of infecting patients in the general hospital population.

And, though it need not be said, when the problem is the lack of doctors and nurses adding profit into the system is not going to solve the problem, only add unnecessary costs.

It also should not have to be said that the lives of vulnerable elderly persons should not be routinely sacrificed to ensure the profit margins of private long-term care facilities, creating a situation where those needless deaths increase exponentially during a pandemic. Being prepared for future pandemics requires that all health care should be publicly funded and operated. Private profit has no place in health care because that profit always has to come at the expense of patient care.

The other need for preparedness is economic. During the COVID pandemic the government scrambled to implement makeshift assistance programs for those economically impacted by the pandemic, and though it helped many it was a very messy solution. What we need is a permanent solution that will not only deal with public health emergencies but also with the economic disruptions of a transition from a fossil fuels based economy to a sustainable energy based economy. What we need is a guaranteed basic income along with a fair progressive taxation system.

There is no justification for not being prepared for the next pandemic.

2022-02-05

Much Ado About Truckers and Building a Canadian White Supremacist Fascist Movement

So what is going on with the truckers. They are calling it a protest. But it is not like any protest I have ever been involved in.

Protests are designed to attempt to make change. While they may be aimed at getting governments to change their policies, gaining public support to pressure government is always an aim of legitimate protests. To get the public’s attention of course you need to get he media’s attention and that usually is done by means of a large protest or some form of disruption.

The truckers are in an excellent position to do that. Large transport trucks take up a lot of space, one truck can taker the space of 100 marching protesters, so they can easily make a protest appear to be larger than it actually is. And trucks can be disruptive. You want attention, block the streets and clog traffic. So do that for a day or weekend and you have the media’s attention and you can get your point across.

Of course the truckers argument against the government protecting the health of it’s citizens is a hard sell to the general public.

So while you might need some disruption to get peoples attention you do not want to alienate the public whose support you are trying to gain.

So blasting neighbourhoods with noise, shitting on peoples lawns, attacking them as they go about their daily business and otherwise harassing and terrorizing them is not what a protest is about. Neither is openly displaying signs and symbols of hate a tactic used to gain the general public’s support. That is aimed at a much smaller target audience.

So what is going on. This is clearly not aimed at gaining public support. Nobody thinks they are that stupid. Something else is going on here.

We have bullies using tactics that appeal to other bullies. I believe it is clear that this is a recruiting move aimed at the worst elements of our society, bringing them together to form some sort of comradeship and solidarity. And one cannot discount the usefulness of this as a dry run for something even more nefarious than terrorizing citizens, but a rehearsal for actual insurrection.

Any actual truckers involved are just being duped and used as pawns in something very dangerous. What we are seeing is just one component of the building of a white supremacist fascist movement in Canada aimed at destroying the very fabric of our society.

2021-04-16

Ontario’s COVID-19 Disaster in Five Words

The Ontario government would like to blame the behaviour of Ontario’s citizens for this disaster implying somehow we are so much worse than the citizens of other countries, and even other provinces, that are at the end of this crisis as we enter the worst of it. The fact is other jurisdictions acted quicker and stronger and got through the worst quicker because they put the health of their citizens first.

Ontario has from the start tried to get by with half measures because the government’s priority was protecting business interests, the sacred economy. Now the government is flailing about trying to appear to be doing something while failing to implement many of the measures recommended by public health experts, and implementing others that will have little impact beyond punishing the citizens of the province for the government’s inaction and ineptitude.

Indeed the priority of Premier Doug Ford is not protecting the health of Ontario. His priority is not even governing the province of Ontario. His priority is reflected in the five words he uttered so proudly “I’m a businessman first”.

2020-06-29

Thoughts on the police

This post does not claim to have all the answers, or any answers, nor to be a comprehensive, or any kind of analysis, but is simply some thoughts on a subject that our society has finally been forced to deal with.

One's attitude to the police is clearly shaped by the reality one lives in. Unfortunately for too many people that reality is that the police are people who at worst kill them or their family members and at best treat them unfairly and discriminate against them. To others the police are people they depend on to protect them and in some cases to protect their privileged status in society.

Some will say this is an issue that we have imported from a racist United States. We know that to be untrue. Even those that say that know it to be untrue and the best they can argue is that it is relatively worse in the United States. Not being as bad as America is hardly a standard we should want to be judged by in Canada, particularly when strong arguments can be made that this is not true anyway, we just all wish it was.

Many will argue that abolishing or defunding the police are simply ideas that are too radical.

Indeed for untold decades suggestions for community building and crime prevention as an alternative to policing and incarceration have been met with support in principle without funding being provided, while police budgets have increased exponentially with little restraint. Indeed there seemed to have be an unspoken argument that we will find money for crime prevention when we no longer need it for the police because crime has disappeared.

We could of course reduce the need for the police by orders of magnitude if we stopped criminalizing what is a public health issue – drug use and abuse. We have done that for years with alcohol and tobacco use and cannabis just recently. There is no rational reason why all non-medical use of drugs should not been treated in the same way as a public health issue.

The funds are available to provide proper drug rehabilitation programs, sitting there in police budgets being wasted on treating a health matter as a criminal one. We could also use that money to provide mental health workers to deal with mental health crisis so the individuals receive treatment rather than being killed by police.

I dare say we have a huge amount of room to defund the police and put that money to better use.

We could put traffic enforcement in a separate organization with a greater emphasis on road safety rather than collecting fines,

What we have left within the police for traditional policing, crime investigation and law enforcement would still require major reforms. Reforms of the extent that could justifiably be argued would be best done by abolishing the police as they now exist and starting all over.

2007-09-20

Public Education and Public Health - The HPV Vaccine

I was all set to go on a tirade against the Catholic school system for attempting to thwart local health units HPV vaccine programs. However it appears that the boards have backed down from their threat to put religion before public health. But it could have happened.

The Catholic Church is free to have it’s religious position on non-marital sex but do the church leaders really believe that Jesus would have thought cervical cancer was an appropriate punishment for engaging in non-marital sex.

Our public health system uses the school system to provide effective and efficient vaccination programs. None of the vaccines provided are without controversy, including the HPV vaccine. But it is the responsibility of our public health system to decide which are appropriate to be provided, not the responsibility of religious leaders. The HPV vaccine program is supported by medical experts as well as federal, provincial and local health officials.

This is just another example of the problem with publicly funded religious based schools. It goes beyond education into public health. The Catholics may have backed down but there are certainly many “Christian” and other religious schools that will not allow public health units to use their schools to provide the HPV vaccine, or perhaps any vaccines. With the extension of public funding to all religious schools this will become a real problem, whether the schools co-operate or not.

The benefit of using the school system to provide vaccinations, and this applies to all vaccines including the standard childhood vaccines, is the efficiency provided by only having to deal with two school systems in each community. With public funding of all religious schools we will undoubtedly have more of them and the effectiveness of using the school system to provide vaccines will be greatly diminished.

And, of course, the effectiveness of sex education to prevent the spread of STDs and HIV/AIDS, as well as reduce teenage pregnancies, will also be reduced by the increased number of religious based schools.

Public education and public health go hand in hand and that is just one more reason to have a single public education system.