Has Public Health Failed Kingston?
I religiously get the flu shot. I find the local vaccination clinics and go out of my way to be one of the first people to get it. Why? Well, I’m one of those “at risk” types, due to severe asthma I’ve endured since birth. This year would be no exception to my streak. While scouring the Internet to find information about the flu vaccination, I learned that I should first get the pH1N1 vaccination, and that it would be available starting on October 27th. Great news, or so I thought.
I was hesitant to go on the first day of the swine flu vaccination clinic. A few of my friends who attended that day passed on their experiences via text messages and tweets. What they revealed was disturbing. Although the clinic opened at 10am, over 300 people were waiting in line as early as 9am. According to KFL&A Public Health, by 11am there were 1,000 Kingstonians lined up, while those who arrived after noon were turned away. To top it off, both my friends and KFL&A Public Health reported wait times as high as 5 to 6 hours.
Around 11am, I received word that pregnant women were being greeted at the door, and brought to the front of the line. This confused me as the person who gave me this information is also someone in the at risk category, however he was not offered a spot at the front of the line. To find out why, I contacted Justin Chenier, Communications Officer for the KFL&A Public Health. He advised that Dr. Ian Gemmill decided to bring pregnant women to the front, and treat them first. Otherwise, KFL&A Public Health made no special arrangements for at risk individuals. And so the question remains, why is KFL&A Public Health treating pregnant women differently from others in the at risk group?
It could have had something to do with the advertising associated with the immunization clinic. Ads in local newspapers indicated that the swine flu vaccine would be given to all ages, and that the seasonal flu vaccine was only for those 65 and over. I originally found the same advert for pH1N1 last week on the KFL&A Public Health’s website, however they have since replaced it with a proper notice indicating that only at risk people should come in during the first week of the clinic. Furthermore, immunization staff have repeatedly stressed that “no one will be turned away”. In other words, first come – first served.
We’ve been assured that 3,000 vaccines are available daily for each immunization clinic. Did they reach 3,000 vaccinations on day one? The answer is no. According to KFL&A Public Health, between 1,500 to 1,700 vaccines were administered on day one. What is more, we’ll never know the percentage of at risk individuals who actually received thier vaccination. Has Public Health failed Kingston? When you consider the fact that everyone was treated the same (with the exception of pregnant women), and the failure to treat 3,000 people per day, the answer is YES.
I’m not convinced that the KFL&A Public Health has recognized the errors, and shortfalls associated with their vaccination clinics. Here’s my shortlist of suggestions to help them in the future:
- Toronto Public Health has recognized the urgency of treating at risk citizens and has created special clinics for them. These clinics turn away anyone who doesn’t fit into the priority, at risk category.
- A consistent message should be communicated. Ads for the first seasonal flu immunization clinics indicated that only people 65 and older could receive the seasonal vaccine. KFL&A Public Health should do something similar for the pH1N1 immunization clinics and stick to it. Also, during the first few weeks they should discontinue advertising that they “won’t turn anyone away”.
- Since KFL&A is not able to administer 3,000 vaccines daily, the left over vaccines should be a alloted to a separate clinic for at risk individuals. This would divert between 1,500 to 1,300 daily to a separate clinic, and treat people deemed most likely to contract, or suffer from swine flu.
I hope KFL&A Public Health does something. However I for one, am not holding my breath. Thanks to Lance McCord for the photo accompanying this post.
I was really annoyed when I heard that they’re not telling not-at-risk individuals to piss off. Cripes.
On one hand, I can hardly blame people for worrying. The media have been hammering us with panic and worry for months. So, the clinics open and everybody shows up. A CBC reporter in Ottawa was told that they “couldn’t” turn away people who were there and not in the target groups, but the reporter didn’t say why.
Gemmill has an interesting history in doing what he feels is right and not necessarily what’s in the public interest. Ask him about publicizing restaurant inspections reports sometime. They’re not our business.
I agree that the KFL&A has failed us.
I'm completely OK with them only administering 1,500-1,700 vaccines/day – they've only got so many people trained to do this sort of thing – and am fine with using the rest of those the next day or the day after. From what I hear, some cities across Canada have yet to receive next week's vaccines and when this supply runs out, they're closing clinics. Kingston, meanwhile, will keep vaccinating.
I do think they've failed, though, on the at risk prioritizing and their location setup.
On the at risk group: Why aren't these people being bumped to the front? According to the calendar, this is an 11 week program. Why not dedicate the first two weeks (9 days, they didn't hold a clinic on the first Monday – that's 13,500 shots at 1,500/day) to the high risk group. If you're not a part of that group – or can't prove it – you don't get in. The next two weeks (10 days, they skip a Monday this time again, but have a Saturday clinic – or another 15,000 shots) could be, say, those who would be in direct contact with those high-risk people (Their parents, spouses, housemates, children and so on. This second group would be harder to prove, though. This would vaccinate 28,500 people (nearly 25% of the population) – all of whom high risk or in contact with someone who is – in the first month.
I also think the location – or at least the handling of it – is dumb. Let's take 3,000 people – all of whom are supposed to be high risk for complications arising from the flu, and cram them into a tight space like the Frontenac mall together. Something like the Invista Centre would have been smarter – there's at least more room out there. Or a ticketing system. If they do 1500 in a day and the clinics run 7 hours (they do), then they do 214 shots/hr – or about 3 and a half per minute (17.5 seconds/needle). If you show up at 11am (1 hour into the clinic – 214 shots given) and grab a number, say, 1,132, they could calculate your approximate wait (your number – shots given * 17.5 would give wait time in seconds; In this example, that's 16065 seconds – or about 4.5 hours) they could take some time off that calculation to make sure the line is always present and tell you to come back (Say, in our example, around 3:00; 11am + 4.5hrs – 30 minutes). This would work with pre-clinic-opening lines, too.
I'm a 27-year old in decent health and not at risk for complications – so I'm waiting. My housemate, however, is in the high risk group and was in line on day one. I'll go get mine in about 2 weeks when the high-risk group has had a chance. And if it's still busy and they're still encouraging only high-risk folks to go… then I guess I wait longer.
I guess some people just don't understand basic politeness.
@tyffanie Really great points, and I have to agree that there should be another clinic dedicated to at risk folks using the leftover vaccines. Obviously KFL&A Public Health didn’t think this through well enough, but as you’ve hinted at, what is more disturbing is the fact that they have done nothing to correct the errors made thus far. Are they too blind, or are their resources simply stretched too thin?
Just for the sake of clarification, what groups of people fall in the at risk category? Obviously pregnant women and those with weakened immune systems, but does this extend to those 65 and older, and infants/young children? Who else?
I went and got my shot today with my 2 year old son and his 8 months pregnant mom. We got there at 9 and the line was already long. Thankfully they took pregnant women with kids first and due to my severe asthma(for which I was smart and brought proof) I was able to get in with them as well(Though even that was by the slim of my teeth). I did see the line move more quickly today than the last time I tried to go. However since most of the people getting the shot today were young kids, it was still very loud and chaotic.
I agree that more thought should have been put into this process. Separate lines for those who visibly fit the priority list, such as pregnant women. It also would have been nice if they had arranged for some sort of entertainment for the kids waiting to get the shot or those who were waiting in the recovery area. That many screaming, crying kids makes any situation less manageable. Hopefully the Health department uses this experience as a learning exercise and is better prepared should something of this magnitude happen again. However all those of us who spend so much time complaining about the system should also be thankful we have one at all.
@Harvey The At Risk groups are as follows:
– People under 65 with chronic conditions (ie Asthma & other respitory conditions, Diabetes, etc)
– Pregnant women (I’ve been told there are immune issues during pregnancy)
– Children 6 months to under 5 years of age
– Health care workers
– Household contacts and care providers of persons at high risk who cannot be immunized or may not respond to vaccines
@ZachR Interesting that you mention a number system. I’ve been told that Public Health in Ottawa have adopted an approach similar to that. You get a number and can wander around.
Thanks for all the responses :)
I’m so glad you wrote this, Tyffanie – and Zach R. My wife is almost 8 months pregnant and was turned away from Frontenac Mall site on the 28th because the queues (of largely non-priority cases) were too long. She did not feel up to continuing to try again every day and can’t stand for long periods of time in any case. There was certainly no attempt to take her to the front of the line (as in Michael’s experience) – quite the opposite.
I completely agree that the distribution of the vaccine has been a shambles so far. The message that ‘people will not be turned away’ has actually resulted in anyone turning up and in reality causing those who actually need the vaccine first (the high priority cases) being unable to get vaccinated. There was no triage to sort high from low priority – which would seem to me to be absolutely essential (although Michael’s experience on the 30th suggests that they are now doing something along these lines) and seemingly no assistance or provision for those who are less able either to get to Frontenac Mall or to stand there for hours.
The story so far has been a depressing combination of individual selfishness and government ineptitude, and what’s worst of all, it is adding to the (otherwise unjustifiable) cynicism that many people I have heard talking about vaccination feel about it. I am convinced the poor handling of the vaccination process so far will result in fewer people being vaccinated than would have been the case.
And then… this week, it was all so different. Organised, quick, efficient, friendly and with proper triage. At least the local public health people seem to have learned quickly and adapted to the situation the government put them in…