Pandemonium

It's not like we didn't know it was coming.

So why wasn't the Government of Canada, and provincial governments, better prepared to roll out the H1N1 vaccination program?

If this week (of Nov. 2) has showed us anything, it's that the health department officials who planned the vaccination program, didn't have much of a plan in place at all.

Long line-ups at St. John's clinics created traffic congestion and frustration.

Changes to the criteria for vaccinations added to the confusion.

The guidelines on who should be first in line for the vaccine changed. People aged 5 to 24 with chronic conditions were added, bumping those aged 25-65 others with chronic conditions like asthma and diabetes further down the line.

There were problems with people jumping the line to get the vaccine in a system that relied on people to be honest about whether or not they met the criteria.

Family doctors were not involved in the program.

The biggest problem seemed to be the logistics; locations for clinics, parking space, waiting areas and figuring out whether people in the lineups met the criteria.

It's not as if the country, or province, didn't have enough time to prepare for this.

In 2006, provincial health ministers met with their federal counterpart, Tony Clement, to assess Canada's preparedness to a pandemic.

At the time a strain of the avian flu had killed over 100 people in Asia and Europe, sparking a debate over when the next global pandemic would strike.

That year the federal government had committed $1 billion, over the next five years, to prepare for a potential pandemic.

Well, the pandemic has hit and it seems there simply wasn't enough preparation.

This province, in 2006, put $4 million in its 2006-07 budget to increase its anti-viral stockpiles and add another 39 public health nurses to the system.

"It's about preparing for the next one and ensuring we have the anti-virals there and ready to distribute, especially to the elderly and people with weaker immune systems who are generally most affected by the pandemic," said then health minister Tom Osborne.

Putting up the money was one thing.

But it seems no one thought about the logistics of producing millions of doses of vaccines, timing of production, shipping to provinces, and distributing to citizens.

In 2006, Osborne said "regional health authorities were putting plans and strategies in place to deal with pandemic influenza should it occur. I believe we are ready, not only in the urban areas but in the rural areas."

Three years later, the fall of 2009 proves Osborne's prediction incorrect.

This province and its health authorities did not have a precise organizational plan in place to deliver the H1N1 vaccination program.

It was simply overwhelmed.

This is a matter that should have been handled with military precision. In fact, we would go as far as to suggest that perhaps the military itself, with its background and experience in organizing large-scale operations, would have been better suited to develop a plan to serve all of Canada, and each province.

Even following the rudimentary protocol for an Emergency Response Plan would have helped.

Having that Response Plan in the works months before the pandemic hit could have eliminated the confusion, frustration and fear. It would have, at the very least, prevented traffic jams and parking problems at clinics, and, more importantly, ensured those who really needed the vaccine got to the front of the line.

But there is no evidence that anyone within government or the provincial health organizations had done anything from 2006 until now regarding an organizational plan for a mass vaccination program. If they did, they certainly didn't communicate that plan to the public, or even engage the public in the planning process.

So what we have now is a "rules change by the day" and "stay tuned for updated information" approach.

And that's not likely to change given that the vaccination program has begun and is stumbling along at a pace too rapid to halt.

If nothing else, however, the mass vaccination program, once it's completed, should undergo an operational review to determine what was done right, what was done wrong, and how to improve it for when the next pandemic hits.

Barbara Dean-Simmons

The Packet, Clarenville