Calling out from quarantine. If Newton could accomplish his best work in his 20s during the Black Death, then I have no excuse to not finish my book. Neither do you.
But I am no Newton.
What we lack in talent, we make up with effort.
So, I have been in front of a screen by 0715 each day for the last month. Bum gets sore by supper and forces me to walk around a bit. An evening shift of editing and reading other people’s stuff inspires me to do better the next day.
I look forward to sunrise with coffee and keyboard. So much for sabbatical. Or is it a real one after all?
Here’s an article I wrote for the Macdonald-Laurier Institute: How We Got in a COVID-19 Fix and How to Start to Get Out.
Actually, with is more accurate. I wrote it with them. They are brilliant. It made the cover feature for March, Inside Policy.
And here is an interview I did in the olden days pre-COVID, a few weeks ago. Second Street is a good organization. They focus on people first to influence policy.
Please forgive my Bob and Doug McKenzie pose for the opening shot. It took years to perfect.
Very sorry to those who keep an eye on the discussions here. I feel terrible for not being more active. That will change soon.
If anyone wants to read 80-100 thousand words of confused thoughts about medicare, I would love your help. I can only accept a few, but if you have time/interest/expertise, please write.
I am SO THANKFUL for the docs covering my practice. Two excellent locums have my practice fully covered (plural: locum tenentes…didn’t know that).
Be safe. Thanks for reading!
Best of luck..
All of the world’s health care systems are being stress tested ; Governmental public health care systems in particular are being tested; political leadership is being stress tested and their various policies are also being stress tested…the Swedes are going in one direction, the Finns, the Taiwanese and Singaporeans in another….let’s wait and see who did best.
The character of various populations affected are being tested and will be tested even more…disciplined societies will survive, the undisciplined may not.
One thing for certain, when the dust settles and the final post mortem carried out, the various health care systems around the world will be judged, reassessed and refashioned, in particular our own public health care systems which failed miserably in the face of the Corona test.
Governments’ main responsibility should be public health and only secondarily primary care etc.,…instead many , having mismanaged their public health care systems many boldly ventured into primary care and bungled that….the first mismanagement throwing the second into turmoil.
Governments should focus primarily on public health and only venture from that field into primary care when they have full command of their primary responsibility.
Paraphrasing an old proverb “ For the want of a nail ( the want of immediate screening at airports and border crossings) the shoe was lost, for the want of the shoe the horse was lost, for the want of a horse the rider was lost, for the want of the rider the battle was lost , for the want of a battle the kingdom was lost …all for the want of a nail…the want of screening and border closure “.
Keep well.
Brilliant: for want of a nail. I had forgotten that one.
Sure love the way you bring in tasty bits to make the conversation so much more fun.
I hope you are well and safe!
Cheers
Thank you Andris for your salient comments.
Don Prior
I totally concur with Andris on the government-public health thing.
Most doctors, on the other hand, are primarily involved with patient care. And that is how it should be.
In entering that realm, the government actually cheats patients, because it naturally diverts resources towards public health. (A perfectly obvious and inevitable conflict of interest.)
As I mentioned in an earlier comment, business avoids this sort of problem within a company or group, by scrupulously keeping the budgets for different initiatives separate from one another. There is a conscious decision on how important each is, and how much money will be invested there. Results are also kept transparent. Expenses and profits are accounted for separately. In our case, that would mean citizens (taxpayers) being aware of (deciding by vote) how much money will go to public and primary, and evaluating results on that basis.
Alternatively, government would only do public, and primary care would depend on private insurance (with a safety net). But if government provides funds all for both, the details of division, must be absolutely limpid. Perhaps two different ministries ? Problem is, though, even ministries are constantly putting their hands in each others pockets…
On another note, unofficial info circulating on federal modelling of the economic effect, apparently tells us that we have a “moderate” scenario, assuming that the economy is open before the end of summer. Failing that, the plan “B” scenario is 1930’s grim. So very likely, old fogies like myself will still be self-quarantining, but the young and active will absolutely have to bite the bullet sooner than the the medical modelers would wish.
Your time management is superb, Shawn. An inspiration to all.
Best,
Gordon Friesen, Montreal
http://www.euthanasiediscussion.net/
Thanks Gordon
Great piece as usual, Shawn
just some feedback from London, ON: so far so good, the quarantine seems to work,
It looks like most of the Family doctors are well-available in our offices these days & managing most of the regular patients needs quite well, so even the places like Urgent care or some WICs which are still operating are not too busy,
CPSO/media keeps talking about fast-tracking IMGs licencing for COVID management, thou I don’t see much extra work available even for the practicing doctors.
In GTA it might be quite a different situation, & I wonder is there a compensation mechanism to support doctors (FFS) who contract/fall ill c COVID on a line of duty & cannot make income for a few weeks – ? Especially if it all gets worse & the society will force the physicians to take over at the critical areas of care, different from their regular duties.
Sorry if the analogy might sound offensive, but if there is a housing boom, the construction industry, banks & realtors are earning well from it, which is perceived quite fair & reasonable ..So in case of a medical crisis, when the physicians put their lives on line, one month of such work should be counted for 5 of regular duties for the front-line workers – ?
..And speaking globally,
from your Article: “In retrospect, our calm, rational approach now looks sluggish and imprudent. It will, no doubt, generate commentary long after we get through COVID-19: were we just trying to be the adults on the world stage, while our peer countries over-reacted? What, exactly, drove us to do so little? Doesn’t the federal department of health exist to protect Canadians from external threats?”
Well, it doesn’t seem to be just a mistake or negligence: there was plenty of lead time & sufficient learnings from different world regions.The government seemed to estimate & calculate the potential benefits of the situation, the economical & political, so it chose to allow the epidemics to work.
From the economical side, the elimination of the most needy/highest demanding part of non-productive population would serve well to the desperate financial situation (which the government brought the country in spite of the years of economical well-being)
And politically, the chaos & fear should bring more power to the government, as people will easier give up their rights & liberties & empower the elite with unprecedented authority, in hope of some protection & stability. And this also comes well in line with the general course of our society over the past years, often described as the “nanny state” or “socialist”-concept, which must be a major under-statement, considering the well-known examples of world totalitarian systems, but those totalitarian world models seem similarly neglected & denied by our fellow-countrymen, as COVID epidemics.. until it came in & became our way of life.
“Cui prodest?” has been employed unmistakably thru the human history to understand the confusing situations. There is no fools at the highest levels of political elite (whatever everymen arrogantly tend to believe).. and the disposure of 16 tons of PPE right at the start of the disaster, extensive international flights with no airport screening & unopposed irregular border crossing does not just happen by lack of judgement.
Wow. Tonnes of great comments here, Alexey. Thanks so much for taking time to share them!
Your cui prodest? (‘who benefits’) comments especially struck me. I sure hope you are as wrong as you are wise for asking in the first place.
You also make me think about the impact on those at the front lines of care. I am no longer in emergency medicine, but I speak with colleagues who are. Everyone is concerned, but especially the ones over 50. Does a one-size-fits-all approach to PPE work for this bug?
Again, far too many great comments to respond with the thoughtfulness they deserve. Thanks for taking time to read and share them!
Cheers
430,000 people flew on direct flights from China to the USA since the Chinese officials first disclosed the outbreak of coronavirus to the WHO authorities on the 31 December 2019…not counting those arriving on connecting flights.
Cannot find the Canadian numbers.
“who benefits” ?
We have a lot of people deeply invested in the idea that industrialization must be scaled back for the survival of the planet. Many of these people are very close to power. Even before the virus, we were asked to shut down energy expansion, and even to accept the interruption of transport upon that rail line which is quite literally the backbone of Canadian Confederation.
And now we have an authentic crisis where economic priorities can be legitimately contested on the basis of other imperative concerns. So, what will the balance be ?
For the progressive climate-warmer/socialists, this is the opportunity of a life-time.
Is it not possible then, that in the vocabulary of the computer programmer, maximum economic disruption and shutdown is not a “bug”, but rather a “feature ?
Best,
Gordon Friesen, Montreal
http://www.euthanasiediscussion.net/