Dr. Robert Van Exan, former director of health and science policy at Canadian pharmaceutical giant Sanofi Pasteur, said tracking with barcodes in Canada “should have been written in the pandemic plan.”There was a plan to make these barcodes central to Canada’s public-health system, and there was a time when Canada was ahead in digitizing its health system “by a decade,” Dr. Van Exan said. Canada’s 1998 vaccine strategy first proposed barcoding vaccines to promote efficiency and accuracy. The 2003 SARS epidemic, and the creation of the Public Health Agency of Canada, hastened that work.In normal times, Canada administers millions of vaccines a year for diseases such as mumps and influenza. Provinces slowly adopted digitized immunization records in the early 2000s, but continued entering all the data manually: Audits of some provincial systems found fully 15 per cent of immunization records were incomplete, nearly a quarter had inaccurate information, and crucial data was missing from one in five adverse-reaction reports.In 2007, Ottawa tapped an advisory group made up of industry experts, including Dr. Van Exan, to plan the implementation of these barcodes. The total cost, the advisory group found, would have then been around $265-million, but they projected savings of $1-billion in the decades to come. They handed Ottawa a plan to start barcoding vaccines in warehouses, hospitals, clinics and pharmacies by 2014.This barcoding capability was an integral part of a broader digital infrastructure project known as the Vaccine Identification Database System (VIDS). Ottawa set up VIDS as a proof of concept for a single, national digitized public-health system to track infectious disease outbreaks and vaccination campaigns.Story continues below advertisementOttawa contracted IBM Canada to build a permanent vaccination version of VIDS, called Panorama. That’s where things “fell off the wagon,” Dr. Van Exan said. “IBM built a system that can’t read barcodes.”Beset by delays and cost increases, some provinces dropped the project. Even some provinces that stuck with Panorama have still not installed crucial components of the system. None of the provinces’ systems work with one another.“This is one of the big flaws in the whole damn system,” Dr. Van Exan said.
I think the trade-offs between privacy and health/safety are due for a re-balancing. I can’t help thinking that there’s a logical answer to the question, “Who are all these people?”. An analogy: investigators of fatal traffic accidents will often report whether the injured parties were wearing seatbelts or whether excessive speed was involved or whether alcohol was a factor. We should have Covid-19 investigators who report what contributing factors the patients have. A possible downside: some symptomatic people would delay getting tested if a positive result would “out” them….a trade-off worth making, I think.
I think Keva can attest to the inclusion of the Brooklyn Tavern in the Top 30.
No, not if this dairy farmer’s experience is representative.
Big Juice: Canadian Juice Council |
If you’ve walked through Carleton’s campus in Ottawa, you may have seen him: A young man working away on a wooden structure just outside the architecture building. He’s building a tiny house, but it isn’t for him — it’s for his mother to live in year-round in Edmonton.
“The current goal is to get him healthy enough to receive another round of chemotherapy.”
Whose “goal” is this? It must be the doctors’ goal – not Ford’s goal and not his family’s.
A lot of social activists object to medical research that inflicts pain/suffering on animals. Where are they when Rob Ford needs them?
I encourage everyone interested in the relative value of “heroic” medical procedures on patients with terminal disease to read Being Mortal by Atul Gawande, M.D. “…when it comes to the inescapable realities of aging and death, what medicine can do often runs counter to what it should.”
Despite his protestations to the contrary, this guy (whose name I’ve already forgotten) is “crazy, posturing—or worse”, but he makes a lot of good points about how and why geezers should moderate their health care expectations and practices.
Let me be clear about my wish. I’m neither asking for more time than is likely nor foreshortening my life. Today I am, as far as my physician and I know, very healthy, with no chronic illness. I just climbed Kilimanjaro with two of my nephews. So I am not talking about bargaining with God to live to 75 because I have a terminal illness. Nor am I talking about waking up one morning 18 years from now and ending my life through euthanasia or suicide. Since the 1990s, I have actively opposed legalizing euthanasia and physician-assisted suicide. People who want to die in one of these ways tend to suffer not from unremitting pain but from depression, hopelessness, and fear of losing their dignity and control. The people they leave behind inevitably feel they have somehow failed. The answer to these symptoms is not ending a life but getting help. I have long argued that we should focus on giving all terminally ill people a good, compassionate death—not euthanasia or assisted suicide for a tiny minority.
I am talking about how long I want to live and the kind and amount of health care I will consent to after 75. Americans seem to be obsessed with exercising, doing mental puzzles, consuming various juice and protein concoctions, sticking to strict diets, and popping vitamins and supplements, all in a valiant effort to cheat death and prolong life as long as possible. This has become so pervasive that it now defines a cultural type: what I call the American immortal.
I reject this aspiration. I think this manic desperation to endlessly extend life is misguided and potentially destructive. For many reasons, 75 is a pretty good age to aim to stop.
His arguments, detailed in his article, would be much more persuasive if one didn’t have to wade through the self-serving bullshit and aggrandizement.
Here’s a silly study. It purports to measure the effectiveness of bicycle helmets by looking at the (minimal) changes in fatality rates since cyclists began using them in droves in the 1990s. The Big Missing in the data is the reduction in the number of serious head injuries resulting from increased helmet usage. Deaths are tragic to loved ones. Head injuries are ruinously costly to families and societies.
This is the first concise summary I found on the effectiveness of helmets in reducing head injuries. The meta-analysis concluded that “helmets provide a 63 to 88% reduction in the risk of head, brain and severe brain injury for all ages of bicyclists.”
The data in the silly study are apparently culled from a 2010Transport Canada study. The article is festooned with Canadian Maple Leafs, suggesting Government of Canada sanction, but it was prepared by a cyclist-rights guy in Ottawa, Ontario. His organization‘s stated objective has been to oppose “various politicians, bureaucrats, safety lobbyists, and misguided members of certain cycling organizations who would have cyclists ghettoized into bike lanes and onto bike paths, and slap foam hats on everyone’s head” The organization is defunct but the website lives on.
Antibiotic Resistance: A Mismanaged Public Good
Yes, we all know that bacteria and other microbial beasties are developing resistance to antibiotics faster than scientists can develop new antibiotics. Same old, same old, right? This interesting article doesn’t offer specific solutions but it opens a door, I think. It suggests that the Tragedy of the Commons phenomenon is a good analogy to the over-prescription and over-use of antibiotics. The costs of over-use are not borne by the over-users; they’re borne by the rest of society. The free market isn’t working. Regulatory intervention may be required to ensure that all the costs are borne by the producers (and thus reflected in their prices.)
Having nicely encapsulated the problem, author Timothy Taylor, the Conversable Economist, offers a few unrealistic solutions to the problem of growing antibiotic resistance:
- invent our way out of the problem with new groups of antibiotics;
- avoid over prescribing antibiotics;
- more hand-washing and sterilization, which would reduce the need to prescribe antibiotics
Seriously – “more hand-washing”?
Instead, why not slap a Federal Excise Tax on the sale of antibiotics used for food animal production? Tasty as they are, food animals are responsible for about half of all the antibiotics sold in the US. The cost of the antibiotics to the farmer is very small; the cost of growing antibiotic resistance to the population at large is very high. Tragedy of the Commons. We should tax the farmers and use the proceeds to bring an NHL team to Seattle – or something else worthwhile like funding basic research into new ways to fight bacterial infections.
What’s that you say, “The farmers are already living at subsistence level* and any further taxes will drive them off the farm and jeopardize our nation’s food independence.”? Corporations, not farmers, raise food animals. If the corporations can’t absorb the additional tax (reducing their profit) they will raise their prices. Yes, this will result in a lot of Meatless Mondays, Tofu Tuesdays, and Wegetable Wednesdays. It’s a small price to pay.
*P.S. Don’t get me started on the subsidies that our governments already pay to the farmers who raise these food animals. That’s the subject for another column.