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Wednesday, November 04, 2009

albertans deserve clarity on h1n1.

If this week had a title, it could be called Ron Liepert under fire. Alberta's Minister of Health has succeeded in shifting the media focus away from Premier Ed Stelmach's upcoming leadership review as the mixed messaging around the H1N1 vaccination plan have continued to dominate the headlines.
"We're not asking only those high-risk groups to get the vaccine first. It's open to all." - Premier Stelmach (October 30, 2009)
"We encouraged all Albertans to get vaccinated. They absolutely took it up by the thousands immediately," - Minister Liepert (October 30, 2009)
After spending weeks urging all Albertans to get an H1N1 vaccination, all vaccination clinics were suspended on October 31 due to low supply. On November 2, Minister Liepert wrote a opinion editorial in the Calgary Herald. The opinion editorial contained a number of factual errors, including claims that other provinces had yet to start implementing their vaccination plans. As of October 28, all ten provinces had begun the implementation of their vaccination programs.

Minister Liepert has described Alberta's H1N1 vaccination program a success, but in the process, he has blamed the shortage on low-risk Albertans who went to the clinics after being told for weeks that they needed to be vaccinated.
"The message has been consistent from Day 1. We have asked only the high-risk Albertans to attend the clinics. That has never changed." - Minister Liepert (October 31, 2009)
As Opposition Liberal leader David Swann and the editorial board of the Calgary Herald called on Liepert to resign, PC MLAs have begun rallying around Premier Stelmach in an attempt to downplay the effect that the H1N1 vaccination issue could have on his upcoming leadership review.

Four hundred thousand Albertans were vaccinated in one week, this is an impressive number, but it does not appear that Minister Liepert had approved any plan that was beyond 'first come, first serve.' After watching a recent video  interview with Minister Liepert, I cannot help but think that he just might be making it up as he goes along.

As Naheed Nenshi recently said on CBC Radio's Wildrose Forum, the problem is that Minister Liepert is reacting as if this were a political problem, rather than a public heath issue. Minister Liepert has allowed Chief Medical Officer Dr. Andre Corriveau to take the blame in the media, but the buck has to stop with the Minister. It was Minister Liepert's job to clearly communicate with Albertans and to show leadership in this situation. He has failed and should resign. If he does not resign, Premier Stelmach should fire him.


Anonymous said...

This is the same health minister who refused to act appropriately when cases of Syphilis started to appear throughout northern Alberta. Ideology clouds this man's judgement at all times.

Someone as unapologetic and obviously incapable of rational thought might get by fine as minister of any other number of portfolios but public health is too important to be left in the hands of such a buffoon. Ed Stelmach is doing Albertans a terrible diservice with every day he lets Liepert stay on in this role.

I think this issue, more than any other, is showing the grassroots of the PC party that Stelmach can not be left in charge much longer. If the party's top brass can't even role out a vaccine properly, what shape will Alberta be in by the 2012 election?

There's nothing wrong with the PC party, but there is something terribly wrong with Ed.

CS said...

Sorry Dave I see it a little different. In my mind the minister and the government role is simply to provide poilicy direction and once that is done let the professionals handle the execution and communication. Alberta media was spoiled with "Sound bite " klien and we do not need the same nonsense again.

These guys are trying to dance to the old music which Albertans started to dismiss with the last election Klien led.

The problem with ministers trying to be movie stars is exactly what you said. They are politically movivated and not practical.

So I guess while I see it a bit different I do agree with you as well.

Anonymous said...

There were committees of health professionals who prepared a report months ago on how to roll this out. It was as you'd expect, high priority first, using proper public health protocols, etc. Report was put in a desk and ignored, and instead the politicos ended up deciding how to do this.

Would like to see that report come out under access to information, and then the political leadership hammered over their decision to ignore it.

eh said...

What happened to Alberta's pandemic plan?

Calgary PC said...

Stelmach would get 95% in the leadership review if he fired Liepert.

Art said...

Ministers do indeed set policy. The government had a pandemic plan in place as others have posted. When officials went to the minister and recommended not using the plan, the Minister had an option.

But that's what happens when you put a high school drop out in charge of a major organization like health care.

We'd be MUCH better off with the bus driver.

Anonymous said...

Stelmach never seems to pass up an opportunity to fail to demonstrate leadership. Fire Liepert now.

Anonymous said...

What's appalling is that David Swann just keeps yapping about the minister resigning. He's the one that should resign!

Erin said...

The only thing that's been consistent at Alberta Health Services lately is confusion.

I guess we can only be thankful that this pandemic is relatively "minor", in that it most people who get it will just get really sick; for most people, H1N1 is not a death sentence. It appears that it will take some poor unfortunate soul who tried to get the vaccine but was turned away - maybe in a high risk group? - to finally force Liepert to take responsibility for this mess.

Anonymous said...

Re Art: Your comment interests me. Wonder why the officials "recommended not using the plan?

Anonymous said...

Great post Dave. I agree. Alberta is lucky that H1N1 hasn't become an epidemic while Liepert is at the helm.

Holly Stick said...

That Summary is dated October 2009 and appears to be the plan they did follow. Page 9 says: "...The vaccine will be offered to all individuals older than six months. High risk groups that will benefit most from immunization are encouraged to get their immunization early. They include: persons under 65 years with a chronic illness, pregnant women, children aged six months to five years of age, people living in remote communities, health care workers and those who care for infants or people with chronic illness..."

Where is the original plan?

Hack said...

Show me blood! I want Tory blood!

Feynman and Coulter's Love Child said...

If only we didn't have a public healthcare system by which vaccination strategies were controlled from a top down central planning role that had little incentive to result in a satisfactory outcome for those interested in the product.

Sorry, but if you get a group of Healthcare Ministers in charge of a program like this it isn't going to be run well. Calling to fire this one guy only to replace him with another guy in charge of the same system is just an excuse for opposition MLAs to show they've made an impact with their own less-than-stellar opinions on the file in question.

jerrymacgp said...

As a health care professional, I would like to inject a few notes of calm rationality into this debate.
- I think it's clear that the demand for H1N1 vaccine was far higher than had been expected and took public health planners by surprise. Public opinion surveys had indicated that less than half the population intended to get either version of the flu shot, and much of the messaging leading up to the rollout of the H1N1campaign was aimed at convincing people to get it, not to delay getting it. When that young hockey player in Ontario died, the panic level among the general public hit a fever pitch and the resulting lineups overwhelmed the clinics that had ben set up.
- Another contributor to the long lineups was the seasonal flu campaign. When this year's flu season opened, public health planners expected to have about four to five weeks to get the annual seasonal flu shots into target groups before the H1N1 vaccine was released. The early release of H1N1 blew a hole in that plan. Many of the people in the lineups, such as seniors, were not at-risk from H1N1 but from seasonal.
- Critics have confused the risk levels. High-risk does not mean high risk of getting H1N1 flu; almost everyone is at high risk of getting it, because it's a novel strain with little natural immunity in the community. High-risk in this context means high risk of becoming seriously ill or even dying of the disease or its complications. School children, for example, are more likely than adults to get the disease, but not more likely to get really sick from it.
- If flu clinics had started out screening for high-risk groups, the lineups might have been shorter, but they would have moved more slowly as nurses carried out the more detailed assessment needed to determine who should or should not receive the vaccine during the opening phases.
- Not every nurse is immediately able to immunize. It's a specialized area of knowledge. Licensed Practical Nurses (LPNs) must take a special course and become certified in order to immunize; while Registered Nurses (RNs) do not need such a specialized course, they do require some form of training and orientation in order to be able to immunize safely, and outside of public health few RNs have received such orientation.

What could have been done differently? In my opinion, suspending the seasonal flu campaign for the general public (only targeting residents of continuing care facilities, seniors lodges, and similar facilities), and training more nurses (RNs & LPNs) to be able to immunize months ago would have been two areas for improvement.

Ignoring the polls and planning for mass demand for vaccine could also have been done, but the risk would have been overstaffing and overspending had the poll results held and turnouts been sparse. Hindsight is after all 20:20.