vaccine – justanoldcountrydoctor

We’ve learned much about COVID-19 since the first infection was announced in 2019. This has helped us develop better treatments and better prevention strategies. We’ve learned that COVID has settled into a fairly consistent annual pattern. There’s a smaller summer wave (end of July to mid-September) and a larger winter wave (November to January). The larger wave ends around the time flu season starts.

This year the summer wave has started in the United States. Wastewater concentrations of COVID are starting to increase in southern and western states (yes they are still low, but they are trending upwards). ER visits with proven COVID cases are also growing in the southwest. So the wave is beginning.

As I write this, the Canadian wave has not yet begun. In particular, the Ontario numbers are still low overall. Local fluctuations are occurring however, and if trends hold as they have done over the past few years, we can expect the COVID wave to start in August, and peak in early September.

The current U.S. wave is due to an Omicron strain of the virus designated as Nimbus. Thankfully, it appears that the Omicron strains cause less serious infections (though may spread more quickly). This means that existing immunity from prior infection and immunizations continue to provide some meaningful protection against severe disease.

With that in mind, what should Canadians do to prepare for this summer wave? For healthy people, I actually think we’ve reached a point where it’s unreasonable to say “avoid COVID at all costs.” With COVID being so widespread and so frequent, our goal should now be to take a risk-based approach.

What EVERYONE Should Do

We all benefit from better air quality, particularly indoor air quality. While all of us love air conditioning, opening windows when practical really helps increase airflow circulation and is very beneficial. Now let’s be clear if it’s an exceptionally hot day, or if it’s a wildfire smog filled day where it looks like the surface of Venus , then obviously the windows should stay closed. But when practical, opening windows is good for air quality.

The View from my office on a recent wildfire smog filled day

Make sure you have HEPA air purifiers. I have one in every room in my office. Putting an air purifier in high volume rooms in your home is a good idea.

Social gatherings should also be outside. Fresh air and sunshine – just what your grandmother ordered.

I appreciate this next bit of advice will go over like a lead stone for some people, but I think it’s important that you keep a few well-fitted N95 masks around as well. You can buy these online. I’m not suggesting you need to wear them all the time, I believe we’re past that. However, in the event that a wave hits and you have to go to a crowded environment, or you’re feeling unwell, it’s better to have these ready and available, rather than scrambling to find one at the last minute.

Similarly rapid antigen tests are also useful to keep at home. You can get these from most drug stores. They are unfortunately a little less sensitive for Omicron than they were against the early variants, but they’re still fairly useful. Again, I’m not suggesting you swab every day if you’re feeling well. But if you do develop flu-like symptoms in August, then it’s helpful to already have the tests at home. Please note that a negative test does not completely rule out an infection, especially during the first 24 hours of illness. Doing a second test a day or two after your first test will improve the accuracy of the test.

If you do become ill, then of course, I would hope that you would have the good manners to stay at home. Symptoms of a covid infection are generally the same as most other respiratory illnesses (sore throat, cough, low-grade fever, fatigue). Most physicians now do virtual visits, and so you can still arrange to speak to a physician or video call them if you’ve got these types of symptoms, without infecting their whole waiting room. If you are sick, please have the common decency to avoid visiting people who have significant health issues, as those people, if they get COVID, have a significantly higher chance of deteriorating rapidly.

Get immunized! Most patients should get a yearly Covid shot, generally in the fall. Enough of the clot shot/fakecine/frankenshot/globalist serum/fauci juice nonsense. By Aug of 2024 over 13.7 BILLION Covid Vaccines were given worldwide (including over a 100 million in Canada). None of overwrought, neurotic claims about how we’re all going to die if we got the Covid shots have come true. Protect your self and your loved ones and get an annual vaccine (click here to get your shot).

And of course, there is the same advice that grandmothers have been giving forever. Eat right, exercise regularly, maintain a healthy weight, control your diabetes, quit smoking, take your vitamins (2,000 international units of vitamin D daily and 500-1000 mg of Vitamin C daily would be a good start for Canadians). Doing all of that will not prevent you from getting COVID, but they certainly are associated with a much better outcome if you do get COVID.

What Those Who are Elderly or Have Significant Health Issues Should Do

In additions to the above, significantly ill or immunocompromised patients might benefit in getting a Covid vaccine twice a year. Please discuss this with your doctor. Additionally, knowing that they are at higher risk, they should be prepared to avoid indoor activities with the general public during the coming Covid wave. For example, many grocery stores deliver now, so there’s no need to go shopping. Avoid larger indoor events where possible. If travelling by bus or plane, just go ahead and wear a mask during a Covid Wave. Call your doctor when you first get sick as you may qualify for some of the newer treatments for Covid.

The last word.

This year appears to be trending for a moderate COVID wave as opposed to a severe one in August. If we all take reasonable, cautious precautions, we can hopefully keep it under control.

I’ve written about the horrific treatment that Dr. Elaine Ma has been subjected to by the bureaucrats at Ontario Health before. The situation is so ridiculous that it could be a story presented at the Theatre of the Absurd.

What happened?

Dr. Ma is a family physician from the Kingston area. During the Covid pandemic she realizes the need to immunize as many people as possible to protect the community. She organizes a number of outdoor mass vaccination clinics, which resulted in Kingston being one of the most heavily vaccinated areas of the province. For her efforts, she wins the very well deserved the praise of many, and an award from the Ontario College of Family Physicians.

There are two billing codes for providing Covid vaccinations. One for physicians who work in a vaccination clinic that someone else set up (e.g. public health). Another for those who set up the clinics themselves, and paid for staff/heating for outdoors/tents/internet etc. Since she paid for all of that, Dr. Ma bills the second code.

Fast forward a couple of years and the callous and unthinking bureaucrats at OHIP decide that she has billed the wrong code and demand she pay back $600,000. I won’t restate all the steps she went through to fight this. I will state that the reasons for them wanting the money paid back varied between the clinic being outdoors instead of indoors, medical students being involved and so on. But eventually the case winds up at Divisional Court.

On Dec 16, the court handed down a ruling supporting Dr. Ma. What I had failed to realize before is that the Ontario Health bureaucrats main argument appears to be that there were no extenuating circumstances during the time of the Vaccine Clinics that Dr. Ma set up. Yes, you read that correctly. The whole country was in the midst of a (hopefully) once in a lifetime pandemic. Canada was effectively shut down for business. People were not allowed to visit loved ones in hospital or nursing homes. Travel had ground to a halt. But, in the minds of the soulless and spiteful bureaucrats, none of this constituted “extenuating circumstances”.

Thankfully, Divisional Court Justices Matheson, Varpio and O’Brien were having none of this nonsense. They clearly stated the decision by bureaucrats that there were no extenuating circumstances was “unreasonable.” (I would have, and will, call that decision much worse things). The Justices pointed out the obvious. There was clearly a public health crisis at the time, and that many leaders, including politicians were calling on physicians to get the vaccinations done.

More importantly they stated something the OMA’s legal team really needs to take a deep dive into:

…”that the wording of section 17.5 does not limit relief to unpaid claims; it only requires the presence of extenuating circumstances. Since OHIP typically pays claims first and reviews them later, a restriction on unpaid claims would effectively nullify the provision. The court called this interpretation unreasonable.”

Currently OHIP pays physicians whenever they bill. Later, OHIP decides if it was reasonable or not, and if OHIP feels the situation is unreasonable, they demand the money back. The justices seem to be saying this process is not fair. Which has implications far beyond this one case. Obviously, this would not apply to clear cut cases of fraud. It is a much much needed kick to the slow, incompetent, and spiteful OHIP review process. I can’t possibly understand the potential future implications for this – but I suspect there will be many.

Finally, the justices let their displeasure be known by ordering OHIP to pay Dr. Ma $10,000 in court costs. This strongly suggests to me that they were peeved at the OHIP bureaucrats for taking it this far, and really didn’t think it should have gone there.

How is this hurting health care now?

Ontario is currently seeing an unprecedented surge in flu cases. Flu season has come early. The current variant appears to be extremely strong. It is circulating at “sky high” levels among young people. Three children (at least) have died. Hospitals have declared outbreaks and wards are closed. Visitation has stopped.

Sign on the door to the Medical Ward of my Hospital

You know what would really help? If only some people would come up with some innovative ways of getting their communities vaccinated against the flu. Yes this year’s flu shot is a bit of mismatch for the current strain, but it still provides some protection and keeps you from getting really ill.

Or how about an innovative idea for where to safely look after patients like was done during the Covid crisis. My friend Dr. Bryan Recoskie set up a unique 18 bed ward in our local Legion, to look after non-covid patients while the hospital wards were shut with covid positive patients.

And yet, I don’t see any of that happening right now. Don’t get me wrong, doctors continue to go to work. We continue to care for the sick and continue to comfort those in need. We continue to do our best in these trying circumstances.

But I can’t find any evidence (please correct me if I’m wrong) – of where people are doing unique out of the box things to try and mitigate the currently unfolding nightmare. Given the potential exists that IF you try something unique, you may wind up undergoing two years of pure hell by bitter, ruthless and depraved bureaucrats – can you blame people for not trying?

To quote a good friend of mine, “The damage has been done. Nobody is going to stick their necks out now.”

What should happen (but won’t):

First, under no circumstances should OHIP appeal the decision from Divisional Court. The mercilessly inhumane bureaucrats need back down. Second, Health Minister Sylvia Jones needs to do what she should have done a year ago – and direct the bureaucrats not to seek any recovery at all from Dr. Ma. It’s just the right and decent thing to do.

Finally, it would really help if Minister Jones issued a formal apology to Dr. Ma for how she has been treated by the bureaucrats. It’s not just the OHIP bureaucrats. Jones’ own communications director, Hannah Jensen claimed Dr. Ma had “pocketed the funds“, a statement that clearly suggested malfeasance.

Do that, and maybe, just maybe, physicians would once again feel comfortable coming up with out of the box solutions for crises that are occurring.

Maybe.

Tag: vaccine

Preparing for the August Covid-19 Wave in Canada

The Appalling Treatment of Dr. Elaine Ma Is Hurting Health Care in Ontario