H1N1

It’s difficult to comment negatively on a major initiative in the city that is providing urgent protection for citizens. Front-line workers (nurses and other officials) are working hard to immunize people against the H1N1 pandemic, but the process initiated by the city’s public health authority has some serious flaws. Efforts and plans being made by multiple levels of government authorities involved in the process seem to be uncoordinated and their priorities are not always consistent. Coupled with this, the media is overzealous on the issue and reporting is often inaccurate and inconsistent.

With a limited initial supply of vaccine available from the start, the primary goal should be to inoculate health care workers first. This could have been done more effectively if initial supplies of the vaccine had been sent directly to hospitals, clinics and other health care facilities (paramedics, etc.). Steps should also be taken to ensure that individual family doctors are inoculated. Extending the priority list as the city has done, without an adequate supply of vaccines available and with only a few injection sites available has resulted in long queues, and serious confusion.

There is no question that this issue is being over-reported by the media. This is resulting in conflicting and inaccurate information being reported on the radio, TV and newspapers. As an example, exact information on who is included on the priority list for early vaccinations has not been communicated accurately by the media and this is still a confusing issue. A report on CBC television indicated that turning up for an injection if you were not on the list would result in one being turned away. Firstly it is unclear what the list consists of:
* Is it just the list of categories (health care workers, pregnant women, young children, adults in high risk categories, etc.)?
* Or is it a list with named individuals?
If it is the former, the decision as to who qualifies is being left in the hands of individual members of the public. If it is the latter, this is personal information, where did this information originate? The public health authority is also responsible for much of the confusion here. Their approach has not been clear or consistent.

It is unclear why vaccinations for the general public are not being handled in the same way as seasonal vaccinations at family doctors’ offices. This would significantly reduce the pressure on public vaccination sites. Public sites present their own special problems; bringing such large numbers of people together in one location for extended time periods increases the possibility of cross-infection before people are vaccinated and before immunity becomes effective. As healthy school aged children appear to be particularly vulnerable to H1N1, why are vaccinations not being made available in school? These measures would all help to relieve pressure on public sites and reduce waiting times to manageable proportions.

Public health authorities are learning from some of these early mistakes and are implementing some of the measures noted here. If all three levels of government were to work together more closely during the planning and preparation stages of a crisis many of the current problems could have been avoided altogether. Effective cooperation between multiple levels of government continues to be a serious problem in Canada, particularly within the Province of Ontario.