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Canada Matt Gurney: Health officials can reassure us all they want, but our system failed

01:10  27 january  2020
01:10  27 january  2020 Source:   nationalpost.com

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Unless the government can promise our troops would be not just authorized but required to protect Canada’s troops, fine and brave as they are, can only ever be as effective as the system they are assigned to serve Matt Gurney is editor of, and a columnist for, the National Post Comment section.

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a sign on a city street: A directions sign is seen at Sunnybrook Hospital, where a patient is being treated in isolation for what Canadian health officials call the first presumptive confirmed case of novel coronavirus, in Toronto, Ontario, Canada January 26, 2020.© REUTERS/Carlos Osorio A directions sign is seen at Sunnybrook Hospital, where a patient is being treated in isolation for what Canadian health officials call the first presumptive confirmed case of novel coronavirus, in Toronto, Ontario, Canada January 26, 2020.

If there was one message Canadians were meant to take away from the update by Health Canada officials on Sunday morning, one day after the announcement that a presumptive case of Wuhan virus has been isolated in a Toronto hospital, it was that we have a system.

The system isn’t working, and probably can’t work, but we have one. And that’s half the battle, right?

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The actual information presented at the conference, featuring Health Minister Patty Hadju and Dr. Theresa Tam, Canada’s chief public health officer, can be summed up concisely. The patient, a man in his 50s, had recently returned to Toronto from China. He was showing symptoms while on the flight to North America, but still got through the enhanced screening in place at Pearson International Airport. He went home and, a day later, to hospital, where he was immediately isolated. The various public health agencies have been communicating well, the patient is isolated at Toronto’s excellent Sunnybrook Health Sciences Centre, biological samples from the patient are being immediately analyzed, with results expected by Monday, and public health officials are working quickly to identify and contact anyone who was sitting near the man on the transoceanic flight. The patient is, by all accounts, doing well in hospital. His family members are being monitored.

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9. “ Failure should be our teacher, not our undertaker. Failure is delay, not defeat. It is a temporary detour, not a dead end. We speak about success all the time. It is the ability to resist failure or use failure that often leads to greater success. I've met people who don't want to try for fear of failing .”

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It all sounds reassuring. That was certainly the point of the entire exercise. “The risk (to the broader public) is low,” was the unofficial slogan of the entire event. But the reassuring words about co-ordination and communication can’t hide the awkward truth — the “system” the officials were so cheerfully describing didn’t work. A man flying back from an epidemic hot zone — and who was actively symptomatic upon arrival at an airport that was on the alert — was screened by officials who were fully aware of the danger … and who then let him into the country.

That’s the failure here. That’s the issue of concern. Everything else that happens afterward — the immediate isolation of the patient, the rapid testing of his samples, the strong communication among health agencies — is nice but not the point. Lauding the emergency response after a preventable incident rings hollow when the point is to avoid the emergency in the first place.

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In our current system , doctors, hospitals and other health care providers are paid by a number of insurers, and those insurers all pay them slightly different prices. A system willing to pay for fewer drugs could probably get bigger discounts than one that wanted to preserve the current set of choices.

That didn’t happen here, and it probably can’t. We have to be realistic. Any system that relies on honestly and self-reporting by people with a strong reason to lie (in this case, to get the hell back into Canada) isn’t going to be 100 per cent effective. That’s not the government’s fault. The grim truth is that what we know so far about this still-unnamed virus suggests that it’s going to be difficult to contain, if not impossible. The Chinese experience so far shows that it can spread rapidly. The precise rate has yet to be determined, but experts currently estimate that every infected person infects approximately 2.5 other people, though it’s important to note that that’s a mathematical average, not a real-life certainty for each individual case. More concerning is the fact that patients afflicted with the Wuhan virus are apparently contagious before they present any symptoms. For perhaps as long as days.

Let that sink in. People can be infecting others before they realize they themselves are sick.

That’s a problem, and that’s the kill shot for any suggestion that voluntary screening at airports is going to prove effective at keeping this out of Canada. People could potentially be arriving in Canada without the slightest clue they have been exposed, and with nary a symptom or sign to be reported or observed. The very first part of this system that our health officials are so keen to tell us all about isn’t only not working, it can’t work, period.

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“ Health promotion is everyone’s business. While it is clear that health services are a determinant of health , they are But when patients assess whether our system as a whole is optimal and whether it works well and needs only If citizens want coverage for these they must purchase a private plan.

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There’s still no reason to expect a major outbreak in Canada, or even to unreasonably fear one if it does happen. Early indications suggest serious but not catastrophic mortality for this virus, and the aggressive quarantining efforts by China may well largely stamp out any general spread amid the global population. There’s no cause for panic — concern, certainly, but reasonable and responsible concern.

But a big part of keeping people reasonable and responsible is going to be honesty and transparency from our health officials. Spinning a soothing narrative of a system that starts with screening at the airports leaves them looking ridiculous when they’re simultaneously admitting that it failed in its first test — and when it isn’t likely to work at all. Having a plan isn’t good enough. Having one with a chance of success isn’t too much to ask.

National Post

magurney@postmedia.com

Twitter.com/MattGurney

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