Archive for: October 2009
H1N1: Baddeck breakdown
For a process that has (or should have) undergone intensive preparation for months, the Cape Breton District Health Authority’s first public H1N1 vaccination clinic, Wednesday in Baddeck, was an organizational disaster. Here’s how one Contrarian reader described it:
I gathered the kids after school and navigated our way through the car-lined streets to the Masonic Hall. We grabbed a spot at the end of the line, several car-lengths back from the corner of Queen & Grant streets. It was typical Cape Breton gathering—lots of chatting and laughing between neighbours, and new friends made with unfamiliar faces.
Many of us who arrived after 3 were parents and we had our kids with us. My kids played “Where’s Waldo,” by finding teachers in the line up. Ahead of me were a young couple with their 15 month old daughter. After an hour, we had inched our ways forward several steps.
Behind me were several older people from the community, including at least one with a walker. We all stood, shoulder to shoulder, four in a row, many doing a two-step to keep warm. By the 1.5 hour mark, the sun had slunk low in the sky, and the wind was much colder. A young mother, who had spent the last hour and a half chasing her toddler, fainted. She was carried inside, while someone held her baby.
While I didn’t mind waiting two hours for the shot, I do wonder if asking people who have young kids, are old and infirmed, to stand outside for two hours, is wise. I also wonder if a clinic like this could not have been set up at the school. There would have been facilities for kids and it would have captured kids, parents and teachers in addition to other members of the community. And those waiting would have been warm inside.
Baddeck is Contrarian‘s county seat. Having been warned about the long wait and the cold, I bundled up in layers and made the hour’s drive to Baddeck, arriving an hour before the clinic’s published closing time. A security guard refused to let me join the lineup. It had been closed, even though the clinic hours had been extended until 7. Contrarian spoke with people who arrived at 10:30 a.m (90 minutes before the scheduled opening), at 3, and at 4:30. All waited in the cold more than two hours. Among other things, they reported that the “informed consent” video all were supposed to “watch,” was hard to see and impossible to hear.
Is there a better way to do this?
Douglas Shenson, associate clinical professor of epidemiology and public health at the Yale School of Medicine, thinks there is. In Monday’s New York Times, he suggested using federal polling stations for rapid, mass vaccinations:
There are about 186,000 polling places in the United States, in schools, centers for the elderly, churches and fire stations in every community. Federal law requires that they be accessible to people with disabilities, many of whom may be particularly vulnerable to influenza…. Public health officials must soon decide how and where to deploy health care personnel to administer the H1N1 vaccine. If the pandemic becomes more severe, they will need to deliver the vaccine to large numbers of people while avoiding crowds that would increase the risk of infection. Sites that are universally available and dispersed across all neighborhoods would be ideal.
Shenson and some colleagues piloted the idea in last fall’s US presidential election on behalf of the Robert Wood Johnson Foundation’s Vote and Vax initiative.
Would this work in Canada? By my back-of-the-envelope calculation, we have roughly 200 polling stations per riding, or more than 80,000 across the country. That’s about five times as many, per capita, as the US (which may be one reason why our paper ballot elections work so much more smoothly than their machine-assisted votes!). Realistically, it may be too many venues for public health officials to staff.
But for anyone who wrangled toddlers or aging parent for two hours in the cold yesterday, having more, smaller clinics, and having them in accessible buildings that can handle a crowd, seems at least worth considering.
Annals of (anti-vaccination) humbug – feedback
Contrarian reader Colin May writes:
Thank you for exposing the Fralic twit. And thanks to CBC Halifax for the Tuesday lunchtime phone-in which answered all my questions.
Many of us have, or had, parents who were cognisant of the diseases which killed many children. Even I remeber the iron lung. Unfortunately we now have a new generation which has little knowledge of the risks faced by previous generations and now listen to all manner of quackery, theory, and new age nonsense. I’ll have the jab because the risk is less than the risk of the disease, and as my RN wife points out, “You may pass it on to other people; it is not just about you.”
Annals of unseemliness: Michel Samson
How sad that Marilyn MacKay, the Louisdale resident who spent two years in Toronto waiting for a double lung transplant, has died just six days after receiving the surgery. Her MLA, Richmond Liberal Michel Samson, apparently deems this an appropriate time to issue a news release mixing condolences with thinly veiled political point scoring.
Elequent testiment to Afghani futility
For anyone who still needs persuading, the Michael Hoh’s letter of resignation as the US State Department’s Senior Civilian Representative in Zabul Province, Afghanistan, bears reading.
As the Atlantic’s James Fallows points out:
[R]esignations on principle are vanishingly rare in U.S. government practice. It’s much easier to keep your head down, protect your career prospects, and when it’s over say that you had been against [failed policy xx or yy] all along. Apart from the merits of his argument, Hoh deserves respect for taking this step so forthrightly. Each person who does so creates an example for others to reflect upon. [...]
The United States [and Canada] entered Afghanistan — properly and with every moral and practical justification — to disrupt, punish, and kill groups that had planned the 9/11 attacks. It is now in a mess in Afghanistan largely because of the crucial misjudgment nearly eight years ago to shift effort and attention to Saddam Hussein and Iraq.
An unfamiliar concept: risk
The Globe and Mail’s André Picard continues to talk sense on H1N1 and the mass vaccination campaign. Moneyquote:
In 21st century Canada, risk is a largely unfamiliar concept. In a country of 34 million people that has nearly 400,000 births annually, fewer than 800 children aged 1-14 die each year. (Another 1,200 or so under the age of 1 die, most of congenital abnormalities.) In Canada, the greatest danger to children is falls and motor vehicle collisions. Deaths from infectious disease are remarkably few, in large part due to vaccination. [...]
So, what should parents do? First and foremost, they should bite the bullet and get their children vaccinated. Pack a book, a GameBoy, and an iPod and get in line. Stand in line and relish the thought that we live in a country where one of the greatest threats to our children is a bug with a relatively small risk. And don’t forget that the risks of the vaccine itself are vanishingly small.
A shocking coywolf attack in Cape Breton – updated
A very sad update: The woman attacked by two coywolves succumbed to her injuries overnight. Deepest sympathy to her family and friends for their unimaginable loss.
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The shocking news that a 19-year-old Toronto-area woman was attacked and “very, very seriously” injured by a pair of coyotes in the Cape Breton Highlands National Park this afternoon will undoubtedly focus attention on recent reports that Eastern Coyotes are in fact a hybrid of coyotes and wolves, or coywolves.
We offer heartfelt hopes for a speedy and complete recovery for the unidentified woman, who was hiking on the popular and well used Skyline Trail north of Cheticamp—a trail Contrarian has often hiked with family and friends. The injured woman has been airlifted to Halifax, where she is in critical condition. RCMP officers who happened to be nearby came to her assistance. They shot and apparently wounded one of the animals; however both escaped into the woods.
CBC Radio’s Quirks and Quarks recently interviewed Dr. Roland Kays, Curator of Mammals at New York State Museum, about genetic testing he carried out on coyotes in that state, indicating that, as they moved east, coyotes interbred with remnant wolf populations:
Coyotes are a newcomer to Nova Scotia, the earliest confirmed specimin having been taken in Guysborough in 1977. The 30- to 50-pound Eastern Coyote is larger and darker than its western cousin, and typically occupies woodlands, not the grassy habitat favored by pure coyotes.
Kays found that the head and jaw of the coywolf are better adapted for taking down the white tailed deer that flourish here. In effect, as the coyote took over the wolf’s ecological niche in eastern North America, it became part-wolf.
The Knight Science Journalism Tracker has links to more stories about the coywolf, including articles from AAAS Science Now, Discovery, and Scientific American.
Canadian Press quotes Nova Scotia Department of Natural Resources spokesman Don Anderson as saying a young Ontario girl was bitten several years ago on the Skyline Trail. “That coyote was put down and sent away for testing and it came back negative for rabies or anything like that,” he said.
Hat tip: SP.
Annals of (anti-vaccination) humbug – feedback
A Contrarian reader who is also a public health nutritionist responds to our post about Fralic’s foolishness:
This Globe and Mail article convinced me of the importance of getting the H1N1 vaccination. There is so much misinfomation out there, and I hold health reporter Andre Picard’s coverage in high regard.
Nova Scotians can find the location and schedule of immunization clinics in their District Health Region here. [On the map, click on your DHA.]
I plan to take [my children] to the Baddeck clinic and get us done before the rush.
Contrarian expects tomorrow’s Baddeck clinic, the first in Cape Breton, to be a madhouse. Some physicians will offer ‘flu shots in their offices.
Hydro Quebecwick? Not just Danny’s problem
This promises to be a continuing Contrarian topic, but I will flag it briefly: NB Power’s apparently imminent sale to Hydro Quebec represents a tectonic shift in Nova Scotia’s energy options.
I mention this because, as is typical, the national news media seem to view the story as just another installment in Newfoundland Premier Danny Williams’s (to them) clownish battles with central Canada. Such a view is as witless as it is patronizing.
The sale poses huge problems for Nova Scotia and PEI, as well as Newfoundland. If Quebec can use its windfall profits from Joey Smallwood’s disastrous 1969 deal on Upper Churchill Falls to buy up all the available routes that might get Lower Churchill Falls power to market, you have to wonder whether Canada really is a country any more.
Nova Scotia needs desperately needs to get off dirty imported coal as an energy source. Of our three local renewable energy prospects—wind, biomass, and tidal—two are intermittent and require large amounts of dispatchable backup energy. (Dispatchable means it can be turned on and off quickly, unlike thermal plants, and when needed, unlike wind and tidal). Pt. LePreau nuclear and Churchill Falls Hydro are the two best only two prospects. To justify the cost of Churchill Falls, we need to be able to transit any excess electricity to New England.
Premier Darrell Dexter speaks bravely about turning the sale, and Newfoundland’s antipathy to Quebec Hydro, to Nova Scotia’s advantage by building an undersea cable from Yarmouth to Maine. That would add a third undersea cable to the project. (The first two would cross the Strait of Belle Isle and the Cabot Strait.) Maine Governor John Baldacci, keen on forging an energy alliance with NB, has previously rejected that idea.
Dexter may by hoping to keep the young’un’s spirits up by whistling past this graveyard, but he must understand that this is first big crisis to face his administration.
A sale would also blows a big hole in nascent plans for a green energy pool involving the four Atlantic Provinces, another potential solution to the problem of intermittentcy of renewable energy supplies.
The Globe and Mail reports that Quebec is holding out a sweet carrot to NB Premier Shawn Graham: wiping clean NB Power’s $4.7-billion debt, and cutting power rates to consumers and businesses by $5-billion. That will be hard for the province to resist, and it goes without saying that no national government would risk offending Quebec by blocking the sale, even if it cripples energy options for three poor-sister provinces.
More on this in the days ahead. Meanwhile, Costas Halavrezos has a good interview with Yves Gagnon, KC Irving Chair of Sustainable Development at Université de Moncton here, CBC-New Brunswick’s estimable Jacques Poitras has some cogent analysis, and, as always, AllNovaScotia is on top of the story (subscription required). Reaction from Williams here and here. The Fredericton Gleaner likes the deal, as does the New Brunswick Business Journal.
A really cool news-aggregator treemap – updated
Marcos Weskamp, a design engineer and “self-taught technologist” who likes to play with data visualization, has created a treemap display of Google News.
Newsmap shows stories as blocks on a grid. The size of the block reflects a story’s rating in Google’s search algorithm. The color of a block reflects its broad subject matter (world, national,business, technology, sports, entertainment, health), selectable with tabs along the bottom. The country of origin can be selected from tabs along the top (like the “Can” tab highlighted in the example above). Rolling your cursor over a block produces pop-up text like the white box above.
Like Google News, Newsmap is highly customizable, so you can preselect the range of stories likely to interest you.
[Update:] The site may be getting a lot of hits. It has been a bit shaky today.
Annals of humbug – Shelley Fralic
In the annals of irresponsible journalism, it would be hard to top Shelley Fralic’s recent Vancouver Sun column pooh-poohing the need for ‘flu shots.
Consider this fair warning to all you germaphobes and nervous Nellies: I will not be getting the swine flu shot. And my hunch is that many other British Columbians of good health and sound mind will also not be heeding the inoculate-’em-all, big and small, entreaties issued this week from federal health authorities, who in an odd singsong of official well-meaning laced with hysteria are encouraging pretty much everyone to line up, in order of priority, for the H1N1 shot.
Inconsistency is no hobgoblin for Fralic. She breezily concedes she has “no argument, of course, with the common sense directive that the swine flu vaccination is a must for those with suppressed immune systems, and chronic physical infirmities such as diabetes, kidney disease, asthma and blood disorders.” Also “pregnant women in their third trimester, natives on reserves, health care workers, and children under five.” She even concedes that the H1N1 ‘flu strain has shown a preference for young, healthy women. But she’s still opposes mass inoculations.
Why? She has “growing unease that our modern society seems inordinately predisposed to the quick-fix petri dish cure for fear a common sniffle might morph into a death sentence, instead of trusting our own built-in immune systems.” She also has “a healthy distrust of drug invention and testing.”
Perhaps Fralic would care to repeat this humbug to the parents and friends of Evan Frustaglio, the healthy, Mississauga 13-year-old who took ill during a weekend hockey tournament and died Monday evening.
Modern medicine has its flaws, but immunization is not one of them. The World Health Organization (WHO) estimates that vaccination programs prevent about two million deaths a year.
In addition, contagion is reduced, strain on health-care systems is eased, and money is frequently saved that can be used for other health services.
When WHO began its smallpox immunization campaign in 1967, smallpox threatened 60 percent of the world’s population and killed every fourth victim. Ten years later, immunization had eradicated the natural occurrence of smallpox.
Since the launch by WHO and its partners of the Global Polio Eradication Initiative in 1988, infections have fallen by 99%, and some five million people have escaped paralysis. Between 1999 and 2003, measles deaths dropped worldwide by almost 40%, and some regions have set a target of eliminating the disease. Maternal and neonatal tetanus will soon be eliminated in 14 of 57 high-risk countries.
Routine ‘flu outbreaks kill 2,000 to 8,000 Canadians every year. Because the H1N1 strain seems to be following the pattern of previous outbreaks that caused far greater mortality, Infectious disease experts recommend vaccination. The benefits of immunization are beyond reasonable argument. Skipping a ‘flu shot out of “a healthy distrust of drug invention” makes as much sense as not scrubbing in before surgery out of trust in “our own built-in immune systems.”
Alas, as Amy Wallace points out, Fralic’s self-indulgent scorn for the science behind one of medicine’s great success stories reflects a growing problem:
This isn’t a religious dispute, like the debate over creationism and intelligent design. It’s a challenge to traditional science that crosses party, class, and religious lines. It is partly a reaction to Big Pharma’s blunders and PR missteps, from Vioxx to illegal marketing ploys, which have encouraged a distrust of experts. It is also, ironically, a product of the era of instant communication and easy access to information. The doubters and deniers are empowered by the Internet (online, nobody knows you’re not a doctor) and helped by the mainstream media, which has an interest in pumping up bad science to create a “debate” where there should be none.
Consider: In certain parts of the US, vaccination rates have dropped so low that occurrences of some children’s diseases are approaching pre-vaccine levels for the first time ever. And the number of people who choose not to vaccinate their children (so-called philosophical exemptions are available in about 20 states, including Pennsylvania, Texas, and much of the West) continues to rise. In states where such opting out is allowed, 2.6 percent of parents did so last year, up from 1 percent in 1991, according to the CDC. In some communities, like California’s affluent Marin County, just north of San Francisco, non-vaccination rates are approaching 6 percent (counterintuitively, higher rates of non-vaccination often correspond with higher levels of education and wealth).
