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Looking for Solutions in Health Care for 2006 and Beyond

Our health care system needs to change to accommodate new demographics, new technologies and new pharmacologic advancement.

The roots of compassion and caring in health care should not change however, and it is with this in mind that the dialogue of change should be had surrounding health care.

How can we adapt to different needs that emerge as our population ages?

How can we  find sustainability in the midst of so many new advancements?

How can individuals become more empowered in serving their own health care needs?

What role does the individual have in enabling the  health care of others  beyond paying taxes?

Many questions like these need to be answered and if we are willing to look with open minds at the problems within our health care system, and beyond political posturing, then we can find new  solutions to take us further into this century. 

 

 

 

 

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Tuesday
Oct212014

Ebola "Terror"?- Not Quite

I have hesitated to wade in with this blog on the subject of the Ebola epidemic in West Africa for a number of reasons.

First, it is getting plenty of media attention elsewhere.

Second, concerns can become overdone and exagerated to the point that the public turns away. If the public turns off then there is a real possibility that politicians back away from providing much needed resources for countries significantly affected and lacking the resources to control outbreaks.

Third, there are plenty of other challenges that we face to our way of life here in Canada. A thoughtful perspective is needed to see that several slowly moving issues such as the demographic shift and homegrown terrorism have greater potential to create severe societal problems here than more acute and immediately horrific events happening elsewhere.

Fourth, when drastic measures such as travel bans to control the spread of Ebola to other countries are raised, the authors are accused of fear-mongering and exagerated response that is harmful to economies and to populations.

BUT, is there really terror in Canada over the Ebola crisis unfolding in West Africa? 

I don`t think so.

Terror or panic is not helpful but I don't think that is what we've got. What there seems to be is concern for what might happen should Ebola go unbridled in West Africa or what happens when it is transported to North America. There is a fascination about this macabre disease and all things morbid.

There ought to be a deeper understanding of what happens to people and economies when we fail to act collectively to hit Ebola type outbreaks hard and fast at the source and when we fail to take necessary measures to stop its spread to other countries. There ought to be an understanding of what happens when public health organizations are starved for funding and seen as acute care`s quiet little cousin. It`s possible that North America`s contact with Ebola has done this.

What we`ve seen initially in the Ebola cases that did arrive in the US, was a degree of calm response bordering on complacency and supported by the concept that what happened in West Africa could not happen in North America. The Ebola infected missionaries returned for care and recovered. North America`s health care system would not allow bad things to happen. Unfortunately, things did go wrong with that approach. North Americans were infected despite best efforts. There have been lessons learned. Terror, no.

While reassurance has its place, it should not be a substitute for taking significant precautions to prevent the spread of serious disease with potential for human and economic damage. There is a time to overdo some measures and to over respond. Some people believe that is fear-mongering. I do not.

While the Ebola cases in the US appear to have been contained and the CDC is now ramping up guidelines for improved protection of health providers, we should not be complacent about risks of emerging disease. They exist. They may pop up when we least expect them and false reassurance and complacency should have no place in our medical armamentarium. Currently, we are not prepared.

Reality is that the slow moving demographic shift and instability grown in other countries and transplanted here pose a much greater risk to Canadian way of life than Ebola even though it is a horrific disease.

We are not "terrorized" by the thought of an economy that can't manage under the weight of expectations or global uncertainties. We don't seem to be "terrorized" by the thought of politicians encouraging euthanasia as a way to deal with rising numbers of frail elderly or people with diseases we can't fix. We don't seem to be "terrorized" by jihadists mowing down soldiers in parking lots. Perhaps we should be. Maybe then we would take our collective heads out of the sand and respond in a meaningful way to the real threats that are more insidious, less immediate, but even more harmful to society and to individuals.

 

 

 

Reader Comments (417)

I just came across this post and it is a must read as well as providing some comic relief!

http://thehealthcareblog.com/blog/2014/10/20/the-antifragile-cdc/comment-page-1/#comment-683851
Public health should be the primary responsibility of governments...in reality they have not done a good job...that has not prevented governments from trudging with their clumsy hob nailed boots into general health care....much like well meaning lumbering Bulls in a china shop, causing unintended and permanent damage with the swish of their tails and their horns as they look around.

Why did the Public Health department stop leading the way on the matter of vaccination for foreign travel? Or on the advisability of foreign travel in general?

In the ' old days' we could phone public health for advice on vaccination for our patients going abroad as per West Africa...today our malpractice Insurance company tells us not to give such advice and refer them to the ' Travel Clinic'(which I'm certain does a good job).

One senses that the EBOLA hysteria will die out soon as no new cases in North America are reported...nevertheless this was a warning bell.
October 21, 2014 | Unregistered CommenterAndris
Safe burial practices seem to be key to reduced transmission of Ebola. Treating the infected seems less productive, at least in west Africa where facilities are scarce.
October 21, 2014 | Unregistered Commentereklimek
R:

It will all be fine. It is just the latest fad.

We all will bumble along with out health care system which covers, well, most acute issues.
October 22, 2014 | Unregistered CommentermovingforwardOntario
ISIS......they're here!
October 22, 2014 | Unregistered CommenterConnieLHINgus
Connie, yes.
More resources are going to be needed for surveillance, security, and changes to how we detain people with radical, threatening ideals.
Despite what Justin Trudeau may think, we cannot turn away.

Canadians must collectively confront the realities at hand. There can be no population health without security.

I'm waiting to hear the banter about inequality as the cause of the attack in Ottawa today which is just an excuse for evil ideology. Poor people are not evil any more than wealthy people are.
October 22, 2014 | Unregistered CommenterMerrilee Fullerton
Regardless of the "root cause" of the Ottawa tragedy, likely we see further reductions in individual autonomy, and more centralization. Maybe, that is the way it should go.
October 23, 2014 | Unregistered CommentermovingforwardOntario
The CDC announced yesterday that they will now emulate the Chinese and require all persons arriving from any of the three affected African Eblola countries to check in daily with temperature monitoring for 21 days. As we know they have also adopted MSF's donning and doffing requirements for PPE.


Seems like the once highly reputable CDC has now become a reactionary organization and while they still may be considered at the top of their game when it comes to basic science research when it comes to Ebola epidemic logistics the organization has been largely a failure.

http://www.thestar.com/news/world/2014/10/22/us_to_monitor_everyone_entering_country_from_3_ebola_nations.html
October 23, 2014 | Unregistered CommenterCanary in a Coal Mine
Clearly the the current penalties are insufficient and undermining what little faith their exists in maintaining the privacy of one's medical records.

Each year all hospital employees should sign a document stating that such breaches will result in automatic firing. Loss of employment as a minimum is the only thing which will may prevent these incidents from happening in the first place.



"A spokesperson for Humber River Hospital has confirmed individuals gained “inappropriate access” to Mayor Rob Ford (open Rob Ford's policard)’s medical records."

http://www.thestar.com/news/gta/2014/10/22/second_hospital_admits_breach_of_mayor_rob_fords_privacy.html#
October 23, 2014 | Unregistered CommenterCanary in a Coal Mine
Almost a decade ago, scientists from Canada and the United States reported that they had created a vaccine that was 100 percent effective in protecting monkeys against the Ebola virus. The results were published in a respected journal, and health officials called them exciting. The researchers said tests in people might start within two years, and a product could potentially be ready for licensing by 2010 or 2011.

It never happened. The vaccine sat on a shelf.

http://www.nytimes.com/2014/10/24/health/without-lucrative-market-potential-ebola-vaccine-was-shelved-for-years.html?hp&action=click&pgtype=Homepage&version=HpHeadline&module=b-lede-package-region&region=top-news&WT.nav=top-news&_r=0
October 23, 2014 | Unregistered CommenterCanary in a Coal Mine
Thanks for the links CICM.
One does question the privacy of electronic medical records.
As far as. MDs coming back to N America after treating Ebola patients, please stay home for 21 days- maybe walk your dog around the block- but please don't go bowling - be overly cautious. It will help rebuild trust. We need that.
October 23, 2014 | Unregistered CommenterMerrilee Fullerton
Realist I agree with your sentiments. Common sense would suggest that if you are a doctor handling very sick Ebola patients in Guinea who then returns to the US your risk profile for contracting the disease would be much higher than a businessman arriving from Guinea. Common sense would also dictate that you shouldn't be getting on domestic commercial flights or subways until the 21 day observation period is up. Stick to your house and go for walks or drives alone but don't potentially compromise the rest of the population's health or generate unnecessary fear and further mistrust by hailing taxis, going bowling, or heading to the theatre.

There seems to be a real divergence of opinion between what the public sees as self-centered health care workers taking unnecessary risks and the so called experts that suggest these high risk health care workers should be able to freely move and mingle with the public as long as they are checking their temperature twice a day.

I suspect the Ebola czar will come down in favour of the public's viewpoint.
October 24, 2014 | Unregistered CommenterCanary in a Coal Mine
The issues recently regarding the active attacks bring up, again, what to do to monitor the 10% more intensely, who draw most of our resources. These two men clearly had been marginalize, and need to be dealt with better. Do we need more ability to aggressively intervene, to the point of denying "rights", in order to better maintain "peace, order, and god government"?
October 24, 2014 | Unregistered CommentermovingforwardOntario
"Stick to your house and go for walks or drives alone but don't potentially compromise the rest of the population's health or generate unnecessary fear and further mistrust by hailing taxis, going bowling, or heading to the theatre."-CICM
I fully agree.

If you are dedicated enough to go to Ebola areas to help, be at least as dedicated not to create mistrust and fear when you return home.

mfo,
It always seems that it is a small segment of society that creates the most concerns either economically or from a social concern. Most people will manage. What to do with the margins?

I don't think the margins can be ignored anymore. While I don't believe that exclusion creates jihadists, I do believe that there is a purpose that is lacking and when combined with drug use/abuse and availability of internet propaganda that is slickly packaged for young men, we have a very dangerous combination.

Come to think of it, the shoot'em up games they play have got to provide some level of excitement that is conditioned by virtual violence that then gets translated to real life. Of course, I don't have the data on that but in combination with the other factors I mention it would seem to create a fertile soil.
R

The difficulty with the margins is that they are growing. The inquailty that isoccurring is widening across all sectors, some can be addressed by increasing taxes, others can't. That's going to have to be realized.
October 24, 2014 | Unregistered CommentermovingforwardOntario
Yes but both of the wannabe homegrown jihadists came from Quebec which I think (please correct me if I am wrong) is the province with the least inequality and greatest access to health and social assistance programs.
October 24, 2014 | Unregistered CommenterCanary in a Coal Mine
CICM

Those in the marginal groups are more frustrated and angry as the gap widens. However, it is not all based on money. There is an intellectual gap building between dedicated zealots who will kill to express their point, and the extreme progressive end, which doesnt get, zealots are zealots!
October 24, 2014 | Unregistered CommentermovingforwardOntario
Common sense prevails rather than the cringe-inducing doc with Aussie accent on CNN last night who said health care workers returning from the hot zone to the US should not have to partake in a 21 day quarantine. Rather they should be able to go to theatres, get on subways, spend Thanksgiving with loved ones, etc.

It is this kind of silliness emanating from the "experts" at the CDC which continues to undermine the public's faith in our public health care systems.

Voluntary quarantines only work for health care workers with common sense and those who will put the community's health interests ahead of their own. After Texas the nurse who got on a commercial air plane twice and now this returning Ebola doc gallivanting around town as if he had never gone to Guinea it is time to put an end to the antics.

Hoskin and Mowat should take notice.

"The governors of New Jersey and New York said Friday they are ordering a mandatory, 21-day quarantine for all doctors and other travelers who have had contact with Ebola victims in West Africa.

snip

Many New Yorkers and others were dismayed to learn that in the week before he was hospitalized, Dr. Craig Spencer rode the subway, took a cab, went bowling, visited a coffee shop and ate at a restaurant.

New Jersey Gov. Chris Christie and New York Gov. Andrew Cuomo said the case forced them to conclude that the two states need guidelines more rigorous than those of the U.S. Centers for Disease Control and Prevention, which recommends voluntary quarantines."

http://news.nationalpost.com/2014/10/24/ny-new-jersey-issue-quarantines-for-travellers-whove-had-contact-with-west-african-ebola-victims/
October 24, 2014 | Unregistered CommenterCanary in a Coal Mine
It matters not what the evidence shows. For the average person who has some level of mistrust of the ability of preventative measures to limit the spread of Ebola, knowing that several Ebola treating MDs and nurses have been out and about deepens the mistrust. Not good.

If these providers are willing to put their lives on the line to treat Ebola victims in Wesr Africa, surely they are willing to curtail their activities for 21 days for the well-being of their fellow citizens.
October 25, 2014 | Unregistered CommenterMerrilee Fullerton
The future. More personal vigilance, more community vigilance, more authority to stop and detain to the authorities. Do we really want to lose personal freedoms, when we know 10% of any society is dysfunctional, and does need more supervision. HealthLinks is designed to capture the health care dependents. Should we have a better structured and functioning Sociallink for those who are socially dysfunctional?
October 25, 2014 | Unregistered CommentermovingforwardOntario
"Should we have a better structured and functioning Sociallink for those who are socially dysfunctional? " -mfO

There are many programs designed and funded to help people with social issues. The real obstacle is that some don't seek out the assistance. Many homeless people live on the street because they don't want to move to a shelter, they have some level of paranoia, rightly or wrongly, about the existing structures to help them.

To date, the state cannot force people to seek help. However, when people post jihadist rantings or are found to be linked to others who want to commit crimes against society, there ought to be ways to "supervise" them in a more fulsome way than what we are able to do now.

There will be some greater level of trade off between individual freedoms and privacy and security. Heck, the young ones don't seem to care about privacy anyway judging from the way they share just about every detail about themselves.

My sentiment is that internet providers are going to have to patrol their own content in a more diligent way. People need to report more often and the authorities need to hit'em hard and hit'em fast.....it may become a game of Whack-a-Mole but it still needs to be done.
Clearly, some type of rebalancing must have to occur. Hopefully, we can rationally balance our desire for reasonable freedom, against the requirement for the "state", representing all of us, to provide reasonable safety.
October 25, 2014 | Unregistered CommentermovingforwardOntario
Maybe just use the public health rules, since we believe the "public health" is jeopardized.

Just "quarantined" until resolved?
October 26, 2014 | Unregistered CommentermovingforwardOntario
A patient of mine who grew up in Quebec said that during the era of the FLQ there was substantial radicalization of young male Quebecers. Prior to the October crisis and the War Measures Act being invoked the police had been given substantial new powers to detain and arrest.

The virus of ideology and its hosts (marginalized males) once againwill have to be identified and quarantined.

"What drives these angry young men? How do otherwise unremarkable sad-sack guys become, almost overnight, self-sacrificing killers? These “lone-wolf terrorists,” as they have come to be known in criminology and intelligence circles, start out with a few troubles, perhaps mental illness or drug addiction or a history of petty crime. Then they suddenly seem to snap, disappear from the normal world, and then burst into the public eye holding the most extreme, murderous sort of ideas. Then they kill, in highly public ways – as Canada has witnessed twice in the past week."

http://www.theglobeandmail.com/news/national/lone-wolf-ideology-or-pathology/article21293910/
October 26, 2014 | Unregistered CommenterCanary in a Coal Mine
Milestone achieved.

"A total of 10,141 confirmed, probable or suspected cases have been reported."

"The WHO has said that many families are keeping infected people at home rather than putting them into isolation in treatment centres, some of which have refused patients due to a lack of beds and basic supplies."
October 26, 2014 | Unregistered Commentereklimek
As for ebola and mandatory quarantine, the chief medical official of each state should just publish their reasons for their recommendations for a mandatory quarantine. Sign their name. Deals done, accept their explanation and their authority to make the final decison. Remove the politics.

If their decison was overridden by a political act, then we have reason to be concerned. If a political decision overwrote, the best medical advice, then there is an issue. In each jurisdiction, we have, as a process, decided to accept public health authority is needed, and must be accepted on behalf of all of us, to remain in good health.
October 26, 2014 | Unregistered CommentermovingforwardOntario
Looks like the US has finally found the right balance on quarantine policy for returning Ebola health care workers,...mandatory 21 day quarantine in their homes.

No more gallivanting around in subways, bowling alleys and coffee shops. Common sense has prevailed.

"Health care workers returning to New York who've had contact with Ebola patients but don't show symptoms can serve a mandatory 21-day quarantine in their homes, Gov. Andrew Cuomo announced Sunday night."

http://www.cnn.com/2014/10/26/health/us-ebola/index.html?hpt=hp_t2
October 27, 2014 | Unregistered CommenterCanary in a Coal Mine
It's long but worth watching... at least the first few minutes:

http://m.youtube.com/watch?feature=youtu.be&t=20m17s&v=UkMKUa0sxBQ
October 27, 2014 | Unregistered CommenterMerrilee Fullerton
dodging accountability

Ebola, "terrorist", Ontario's health system,etc.

It is a systemic issue. No one in charge wants to take the blame when things aren't working well. It hurts to be accountable when things aren't going well.

Bluntly, that's why you get paid well!
October 27, 2014 | Unregistered CommentermovingforwardOntario
A provincial Ebola webcast organized by the Ontario Hospital Association for its members is cancelled at the request of the Ministry of Health and Long-Term Care "for a couple of days".

Yep. Nothin' to see here, folks...we have it covered. We don't need none of yer fancy book learnin' neither.

It's official. We learned nothing from SARS.
October 27, 2014 | Unregistered CommenterExecutive Lead Blogger
It sounds as if the government/ MOHLTC and the policy wonks are all in a huddle trying to devise the next play....they've watched the reactions to the various EBOLA strategies proposed by states such as New Jersey and are going to try devise as politically correct a policy as possible.
October 27, 2014 | Unregistered CommenterAndris
mfO,
Yes. I find it odd that people would resent being quarantined for 21 days after treating Ebola patients abroad. You would think that after witnessing the devastating disease they would understand why precautions need to be taken.

I find it somewhat selfish.

It is challenging to ask, but what evidence is there that the foreign health care workers are stopping spread in West Africa? I do not discount the care that they provide to the suffering patients. On a broader scale, is there evidence to demonstrate that American health care workers have prevented Ebola from spreading?
ELB

All of these lack of conference issues, arising from a government that claims "transparency"! Nothing has changed. Backroom deals continue.

R:

Ebola will fade out. It would be so nice however to have a proactive response stand, rather than a hidden one. Ontario's policy, as of now, is reasonable, and given no cases, it is politically wiser not to comment on "quarantine" without the problem being present.
October 28, 2014 | Unregistered CommentermovingforwardOntario
<<Backroom deals continue.>> - mfO

You cannot "backroom" Ebola.
October 28, 2014 | Unregistered CommenterExecutive Lead Blogger
Not sure leaving it up to public health will work.

"The Winnipeg Regional Health Authority says it is experiencing the worst and fastest-spreading outbreak of infectious syphilis ever recorded."

It seems careless disregard and ignorance spread disease.
October 28, 2014 | Unregistered Commentereklimek
"wild fire" syphilis, drug resistant gonorrhea, drug resistant TB, antibiotic resistance and on and on...its not pretty.

"Yep. Nothin' to see here, folks...we have it covered. We don't need none of yer fancy book learnin' neither."-ELB

Ha. What amazes me how Minister Hoskins, because he has been to Africa in the past and has trained at a public health institution is now an expert on Ebola.

The politicians are quivering in their boots about what might happen to the economy should FEAR spread. They are less worried about Ebola spreading it seems but we have no idea what happens to Ebola once it hits the cities. All we've had in the past is rural outbreaks that have mostly been fairly quickly contained. That's not happening this time.

The concern surrounding health care workers being deterred from going to West Africa to help is misplaced. There is no use having them go and risk returning with the virus if they are not able to make significant impact on the outbreak. It is likely sending soldiers into battle with no ammunition. The US is sending the military which I would expect would have had some training dealing with hazardous material. This action poses a risk to soldiers but it is about the only way to stop the spread. A few MSF MDs and nurses here and there seems to be helping a little but the spread is exponential.

Nassim Taleb criticizes the experts who claim that we should be concerned about other diseases already present here. It is the rate of spread of Ebola that is concerning.

The culture of small villages in Africa seems to be one of suspicion. Recollect that a batch of aid workers were slaughtered in the last six months. The villagers had some level of paranoia. That's hard to beat.

So, its noble of health care workers to be going to West Africa to help, but don't do it as an opportunity to take selfies in your full protective gear. Don't do it because you want to be seen as a hero. Do it because you think it is the right thing to do and be willing to suffer the consequences.

Overall, I doubt very much in the ability of small numbers of health care workers to stop the spread. Dealing with the rapid expansion of Ebola currently needs greater resources even though there are billions being spent on it.

The African economy will take a hit. There needs to be a military presence not only to assist in helping contain the disease but to be present if the situation spirals down into worsening chaos. Average age across Africa runs between 17 and 21 or so.

Ask yourself what happens to a country with millions of young people without resources and without strong leadership?
It's also interesting to note that the CDC, with its expertise and the agency people are being told to trust, did not identify the outbreak in West Africa as a severe threat early. Why not? If it knows so much about Ebola what did it miss? What is different this time?

Certainly, if the CDC and the experts knew all there is to know about Ebola and knew that stopping it at its source was the solution, they would have said,

"Oh, looks like an outbreak in West Africa has serious potential to spread this time. Let's rally to stop it before tens of thousands of people die and before it spreads across the ocean."

But they didn't because they could not have predicted, based on what Ebola has done in the past, that it would spread as quickly as it has this time.

I say the experts need to take a dose of humility, act prudently by over responding and then ease back as real evidence proves the measures like quarantine unnecessary.

Instead, we see the political efforts to stop dissenting voices from speaking out.

Paraphrasing Nassim Taleb, I'm not afraid of Ebola, I'm afraid of the experts who aren't afraid of Ebola.
"I am not worried about #Ebola, I am worried about arguments to not worry about Ebola/how regular pple are more rational than intellectuals."-Nassim Taleb
From the article:

"The argument that the US should be more worried about a disease like cancer — which has more stable rates of infection than Ebola does currently — is a logic that Taleb calls "the empiricism of the idiots."

The basic idea: The growth of Ebola infection is nonlinear, so the number of people catching it doubles every 20 days. Because of this, you have to act quickly at the source of infections, he says. "The closer you are to the source, the more effective you are at slowing it down ... it is much more rational to prevent it now than later."

The problem Taleb sees is that if there is not more urgent action in Liberia, Sierra Leone, and Guinea — to the point of restricting travel and other measures that may now seem like an overreaction — then there will be consequences here.

"If you have to overreact about something, this is the place to overreact," he said.

Read more: http://www.businessinsider.com/nassim-taleb-heres-what-people-dont-understand-about-ebola-2014-10#ixzz3HRyNFYBr
"Pundits who do not find it irrational to have a fire alarm & evacuating when it is triggered find it "fear monging" to worry about #Ebola."- Nassim Taleb
Realist,

I agree with your assessment on the motivations of why a health care should want to travel to assist with the Ebola outbreak in West Africa. Unfortunately in this day and age of hero worship there are some health care workers who head to the hot zone not so much out of true concern for Africans but more about creating a hero self-image back home upon return, and I suspect the most vocal of those resisting a mandatory home quarantine upon return are part of this group. We need more Kevin Vickers types in West Africa dealing with this epidemic rather than those looking for an adventure or who expect a hero's parade when they return home.

Having health care workers knowing before departure to West Africa that they must spent 3 weeks quarantined in their homes may well see a drop in the total number of health care workers applying to go, however those that remain will likely be more serious candidates and heading off to help for the right reasons.

We and the West Africans can do without the health care workers who feel entitled to hit the bowling alley and Starbucks with friends the minute they arrive home and who must make plans to flit off again before the adrenaline fix wears off.

Looks like Australia is closing its borders to travelers from West Africa.
http://www.cnn.com/2014/10/28/world/asia/australia-immigration-policy-ebola/index.html?hpt=hp_c2
October 28, 2014 | Unregistered CommenterCanary in a Coal Mine
5,000 more health care workers estimated to be needed.
Imagine trying to adequately screen thousands of workers on return. If even a few are positive without a sufficient screening...

http://www.ctvnews.ca/health/5-000-ebola-health-care-workers-needed-in-west-africa-1.2074671
This is what happens when politicians want to "do the right thing".

" Florida’s Governor Rick Scott signed a strict executive order mandating twice-daily 21-day health monitoring by state health officials for people returning from Liberia, Sierra Leone and Guinea, regardless of whether the travellers show symptoms or not. ...
Scott said he decided to move ahead with the order when the CDC failed to respond to a request for more information on the risk levels posed by travellers returning from the region."
October 29, 2014 | Unregistered Commentereklimek
eklimek, I think it is more about what happens when authorities fail to communicate sufficiently and responsively and what happens when initial advice/protocols are changing and insufficient.
October 29, 2014 | Unregistered CommenterMerrilee Fullerton
I think I read these military quarantines will take place in Italy which the Italians are not too happy about.

"Defense Secretary Chuck Hagel on Wednesday approved strict, quarantine-like monitoring for all U.S. troops returning from the Ebola relief mission in West Africa, the Pentagon said.

Hagel signed a memo asking top military commanders to develop an implementation plan to place U.S. military personnel returning from Ebola-affected countries into a “21-day controlled monitoring regimen,” Rear Admiral John Kirby, the Pentagon press secretary, said in a statement."

http://www.theglobeandmail.com/news/world/us-nurse-fights-maine-quarantine-over-ebola-fears/article21363477/
October 29, 2014 | Unregistered CommenterCanary in a Coal Mine
So they ramp up monitoring only when a VIP patient is admitted. The rest of the time there is likely little to no monitoring of snooping unless a recurrent pattern or a high volume of unauthorized access is seen. The slow leak type of access probably goes undetected in the large majority of cases. The Newfoundland administrator had inappropriately accessed records over a thousand times before she was caught.

I would be willing to bet there are some very strong forces looking to gain access to Jian Ghomeshi's health care records. If I was him I would be very worried about privacy breaches especially if those records are stored electronically. When we had our VIP patient and the National Enquirer became involved the patients paper chart was removed from the clinic and put in a secure offsite place. Despite this precaution the police were involved because it was determined that a very significant amount of money was on the table for the patient information the tabloids desired.

Fortunately an arrest was made and the person was successfully prosecuted but not before our garbage outside the clinic was searched and clinic staff was called at home requesting information. What was most worrisome and this vulnerability still exists today is someone did manage to access some of this patient's laboratory records by calling the lab with the patient's name, DOB, and OHIP number and the physician billing number. The person who called the lab impersonated the physician in order to gain some results but out of sheer luck did not receive the one they desired. The police were involved with this lab leak as well.

http://www.thestar.com/life/health_wellness/2014/10/29/hospital_privacy_violations_rife_in_ontario.html
October 29, 2014 | Unregistered CommenterCanary in a Coal Mine
CICM,
Interesting times!
I've never had the National Enquirer hanging about the office...must have been quite an experience.

"would be willing to bet there are some very strong forces looking to gain access to Jian Ghomeshi's health care records"

No kidding.

It seems that Jian Ghomeshi doesn't seem to care too much about privacy the way he has written about his sexual practices all over Facebook....to each his own perhaps but I do think that there are still social norms that exist and he would be considered to have gone beyond them. Some would say otherwise but the line does need to be drawn. Concept of personal privacy is morphing into a very strange beast indeed.

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