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Friday, July 31, 2009

Acute-care H1N1 flu guidelines updated

With the H1N1 flu pandemic expected to return with a vengeance this fall, and with a vaccine not predicted to be ready until later in the season, the Public Health Agency of Canada has revised its guidelines for physicians and other health professionals working in acute-care clinics and emergency departments to try to keep the virus's spread under control.

Most of the agency's recommendations will not come as a surprise: masks, gloves, hand-washing, hands-free trash cans, isolation of suspected cases, and so on all the way up to N95 respirators and the use of eye protection as "droplet precautions."

But there is one stipulation, under the "source control" section of the guidelines, that bears emphasizing: "Remove magazines and toys from the waiting rooms to reduce potential contact exposure."

Haven't the media suffered enough, with all the buyouts, layoffs, hiring freezes and newspapers and magazines declaring bankruptcy? And now the H1N1 flu, already a threat to global health, has become the latest threat to publishing solvency as well.

In all seriousness, though, physicians, clinic managers and hospital administrators may not recognize the dangers presented by years-old copies of Sports Illustrated or Maclean's and those mesmerizing balls-on-cables toys doctors seem to love (see right). And while that may sound silly, it may be the difference between safe operations and rampant infections throughout your clinic.

Read the full text of the guidelines here. Other recently revised guidelines for health workers in longterm care facilities and emergency response workers are available here.

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Thursday, July 30, 2009

Barack Obama feels the repercussions of the Chaoulli decision

There's one Canadian who should scare Barack Obama more than any other these days, and it isn't Guantanamo Bay prisoner Omar Khadr.

It's Shona Holmes, the Ontario woman who is among the first Canadians to put the Supreme Court's 2005 Chaoulli decision to the test outside of Quebec.

The court's decision in the Chaoulli case, which pitted the crusading Montreal physician Jacques Chaoulli and a Quebec patient against the Quebec government, established that bans on private health insurance violate the Charter of Rights and Freedoms when wait times to access medical care are so long as to endanger patients' health. (Read the decision here.) That principle hasn't been extended beyond Quebec's borders, but several cases -- including the one Ms Holmes is involved in -- are trying to change that, as I reported nearly two years ago.

So what does Barack Obama have to fear from Ms Holmes? Well, Ms Holmes claims that she had to flee Canada to the United States to get a brain tumour treated before it would kill her. And although that claim has not been proven in court (the Ontario government only just finally filed its defence in her case earlier this month) she has become the poster child of late for the US Republican Party's campaign to make the Washington, DC healthcare-reform battle Obama's "Waterloo," as one representative put it.

Ms Holmes has appeared in a sharply partisan anti-"nationalization" advertisement that's been broadcast across the US:



And she was recently featured at a Republican Party news conference, where she described her plight at the hands of the Canadian healthcare system.

The net result of this has been twofold, and both aspects have been sadly predictable: firstly, the demonization of the Canadian healthcare system; and, consequentially, a serious political problem for the Obama administration and the Democratic Party, which is attempting to draft major health-insurance-reform legislation. Despite the fact the Republicans' reliance on the Canada-is-socialist-and-bad narrative is misleading, the party's influence and the reach of its advertising and the advertising produced by associated political groups all but ensure Canada looks awful, and thereby represent a serious threat to the American reform project.

Shona Holmes, and other Canadians like her who have either entered the US political scene of their own accord or have been pulled into it by lobby groups, are very much at the centre of that regrettable mess.

Photo: President Barack Obama listens to comments while meeting with healthcare stakeholders in the Roosevelt Room at White House May 11, 2009. At right is Health and Human Services Secretary Kathleen Sebelius. Pete Souza, US Government

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