When the truth hurts in health care

While their colleagues pussyfoot around and speak in tongues, we have a group of six Manitoba doctors to thank for shaking things up and telling us what we need to know about the innocents caught in our overburdened healthcare system.

Admitting that their candor won’t win them any favours with the healthcare and political hierarchy, these six docs have pulled back the curtain on the stark reality of COVID-19 and its toll.

Yes, we have to remain vigilant and positive, they said. But we also need a reality check.

This week they spoke out about the critical situation in Manitoba and the same grim picture that has played out across the country in varying degrees.

We all know that hundreds of thousands of so-called “elective” procedures such as surgeries, diagnostics and treatment have been postponed for months here in Ontario and elsewhere as health care resources focus on the pandemic.

I have friends and relatives who have waited months for surgery or tests that were in some cases imminent but got deferred once hospitals began filling up with Covid patients.

Truth to tell, most of our hospitals were at near capacity before the pandemic struck. Simply put, we need more hospital and longterm care beds and it’s becoming increasingly apparent that we are ill prepared for an aging population with ever more complex medical needs.

In recent months, more than 2,500 patients have been transferred from Toronto to receive life-saving care in other centres and the Kingston Health Sciences Centre has received about 100 of these, arriving by ambulance and helicopter.

Imagine waking up to learn that a loved one in isolation at a local hospital has overnight been airlifted to another hospital in another province hundreds or thousands of miles away.

The Manitoba docs say straight out that the word “elective” is misleading. It would suggest to some that this refers to surgery of a cosmetic or non urgent nature when in fact they say their cardiac patients waiting at home for surgery have died from burst aneurysms.

Malignant tumours go undetected, grow and spread and become more difficult to treat the longer patients wait. Deferred bone surgery means patients in severe pain can become severely addicted to narcotics. Sufferers of Crohn’s and other diseases will be much more difficult to treat once medical services are re-opened.

“With the whole health care system focused on fighting COVID-19, we can’t get these increasingly urgent procedures, the referrals, the investigations or the needed hospital-based treatment for our patients,” said Dr. Christine Peschken, a rheumatologist.

As well, the doctors worry about survivors of COVID, especially those who have been on ventilators. The psychological impact on patients and to their families is major.

Dr. Eric Jacobsjohn, an intensive care specialist said, “I think we will have an epidemic of post traumatic stress disorder when this is all done.” His colleague, Dr. Pam Orr, an infectious disease expert, warns that many survivors “will never be the same” and there’s a shortage of rehab services available to help them.

In addition, of course, is the other mental health carnage caused by pandemic isolation, job losses, business failures, closed schools, addictions and other factors.

Contrast this candour and forthright manner with an update by the Prime Minister, two of his cabinet ministers and Canada’s two top public health officials, which directly followed CBC TV’s coverage of the Manitoba doctors’ public statements.

Same old, same old. Business as usual. Nothing to see here.

“Lots of reasons to be hopeful….the federal government will do whatever it takes to protect Canadians….we’ll always have your backs….we’ll have a better summer,” assured Prime Minister Justin Trudeau as he does at each of these regular offerings, which began so many, many months ago.

The federal spokespeople were overly anxious to focus on their notes and speaking points. The day’s headline was that more than half of all Canadians have had their first shot of vaccine, that every Canadian will have their first shot by the end of June and every Canadian will be totally vaccinated by the end of September.

(No mention that as of today less than 5% of Canadians have received their second shots.)

After Canada’s original deal with the Chinese to supply us with vaccine fell apart (probably through no fault of our own except our naivete that we could trust the Chinese authorities), the Trudeau cabinet shopped elsewhere. It scrambled to put together a “diversified portfolio” of vaccines with several drug companies for a total of 44 million doses.

Following that supply chain is like playing Where’s Waldo?

Asked by reporters for an update on shipments of the Moderna vaccine, things turned pretty fuzzy wuzzy.

Canada’s top public health doctor, the unflappable Theresa Tam, was asked for an update on the availability of vaccine supplies but she quickly passed that hot potato down the table to Anita Anand, minister of public services and procurement, who is in charge of Canada’s negotiations with the drug companies.

Originally, Canada was promised it would receive 12.3 million doses of Moderna by the end of June.

Now, the June date seems uncertain and so is the actual amount of vaccine that will be shipped.

Without definite dates of delivery of what drugs, Ontario’s vaccine booking and rollout plan remains chaotic.

Groups like family doctors and pharmacies and various business and volunteer groups are itching to get the vaccine so they can help get shots in arms and make it safer for the public to regain some degree of normalcy.

At a parliamentary committee last week, MPs were told that all the companies contracted to supply vaccine to Canada are paid in advance, according to the agreements. (All other details remain a state secret, including how much we’re paying per dose compared to other jurisdictions. All this secrecy no doubt contributes to vaccine hesitancy for some.)

“Surely, the Moderna contract included a date of delivery,” a cheeky reporter suggested to Minister Anand. Could the drug company face legal action if the vaccine is not delivered on time?

“Moderna is not in breach of the contract,” sniffed the minister. Next question.

It’s obvious that our federal government believes this is no time to get snotty with Big Pharma just like it’s afraid to further tick off Big China.

It’s healthy to see that In Manitoba, some doctors are angry, speaking out and demanding change even if some of their professional colleagues and political masters are uncomfortable with their decision to do so.

One should keep in mind that in Canada, our health care institutions and staff are at the mercy of the policies and funding of governments and the people who run them. It’s understandable that some are reluctant to bite the hands that feed them.

For successive governments, limiting the number of beds and doctors has long been an effective tool to try to contain health care costs.

Our universal health care system is the envy of many but the pandemic has laid bare many of its faults and exposed the critical need for change if we are to meet ongoing and future challenges.

Closer to home, people in the health care field know and share these concerns.

We need them to speak truth to power and level with us like the docs in Manitoba.

We’re told that we’re all in the same boat. Let’s remember that we have the right to question the decisions being made in the wheelhouse and a responsibility to help those who have suffered most from this long, very bad trip.

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