Friday, November 06, 2009

The Swine Flu Lottery

The swine flu season is in full swing and vaccination campaigns have just started in Montreal. As usual, all kinds of weird/bad decisions have been taken, that make you wonder sometimes... We're not talking only about the massive disorganization of the first few days that forced parents with young children and pregnant women standing in huge lines for 5-6 hours in the cold. Consider:

Montreal is the largest city in the province of Quebec, it's where the flu pandemy would have the most disruptive impact. So of course, it's not where the vaccination campaign would start, because that would be too rational. Montrealers would be among the last to be vaccinated in the province.

Why did it take so long? Here's an extract from the local newspaper The Gazette :

"Quebec Health Minister Yves Bolduc chastised Montreal's top health official for failing to deploy the city's H1N1 vaccination program as planned months in advance.

Concerned that further inoculation delays would put people at risk for swine flu infection now that the virus is in hyper speed, Bolduc personally called David Levine, head of the Montreal Health and Social Services Agency, to demand an explanation.

Bolduc made the call late Monday night, said his press attache Marie-Ève Bédard.

There was no reason for Montreal's delay, Bédard said.

Not only did the city have the vaccine on hand "for quite a while," but also the authority to hand over the doses to the 12 local health agencies responsible for handling the campaign at various sites, she said. "So the minister found it difficult to understand why Montreal hadn't started its vaccination." Levine promised that the plan would be on track by 10 a.m. yesterday, with the vaccine delivered to every hospital, clinic and nursing home.

But at a press briefing held yesterday morning, Levine said that as far as he was concerned, there were no delays.

Accompanied by Richard Lessard, head of public health, and Louise Massicotte, in charge of the vaccine program at local health agencies, Levine explained that plans initially called for a mid-November start date and it was a huge logistical job for the agency to prepare for an earlier start on Oct. 26.

In fact, Lessard added, it was actually a good thing that Montreal did not start immunizing Monday because only that evening the vaccine manufacturer provided health authorities with new handling directives.

Sensitive to light and heat, the vaccine itself must be kept at temperatures between 2 to 8 degrees C, and if not used within 24 hours of being mixed with the adjuvant and one hour of filling a syringe, it will expire, Lessard said.

Back in Bolduc's office, Bédard, however, dismissed these "new" vaccine directives: "This is the first time I've heard of this. I don't know why he said that. The procedures have been known for a long time ... and Montreal was in charge of sending (early) vaccine to northern Quebec." Neither Levine nor Lessard was available to comment."

So there's your answer. As a professional linguistic expert, let me translate: Q: Why the delay? A: Heck if I know.

Vaccines are now limited to people who care for infants, children 6 months to 5 years old, expectant mothers more than 20 weeks pregnant, those with serious immune deficiencies, the gravely ill, front-line and health workers.

For healthy adults and children older than age 5, vaccination will not begin until December 7th. I'll be taking a couple of trips at the end of the year, starting on the first of December, so I guess I'll miss the whole thing. Unless I pull rank with my diabetes, since adults age 18 to 65 with a chronic illness will get inoculated starting November 23rd.

In the meantime, here are a few groups who are getting their shots ahead of everyone: hockey players, inmates in jail, high-level civil servants and homeless people.

Any questions? Ask the health care professionals below (no, not the pumpkin, he's a PR guy).

Update: I will regularly update this post by adding new groups who I learn are able to jump the line and get inoculated before their turn :

7 November: professional basket ball players, the 200 top donors to a hospital.

10 November: Claude Dubois (famous singer) and family

11 November: Afghan detainees in Canadian bases in Afghanistan (I kid you not)

12 November: "In B.C., where eight died from the swine flu last week, an alleged nurse posted an ad on to auction the H1N1 vaccine on the Internet. The ad, posted Monday, "said the auction would continue until midnight on Friday. After that, the nurse was to contact the highest bidder, come to the winner's home with proof of credentials and administer the shots," The Province reports"

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