When bad things happen, we look for someone to blame. In the current H1N1 flu scare, the spotlight is naturally falling on public health authorities.
Why weren't they ready when the second wave of the flu struck this fall? How come they told everyone to get vaccinated then ran short of vaccine, causing the lineups we're seeing at vaccination spots around the city? Didn't Toronto learn anything from the SARS crisis?
These questions are understandable given all the concern about H1N1, but putting all the blame on Toronto Public Health and other health authorities is simplistic and unfair. H1N1 is a complex threat. Authorities must try to anticipate how the pandemic will progress, no easy task with a new strain of disease. They must devise, produce and distribute a vaccine to millions of people. They must warn people about the dangers of the virus without causing a panic. Given the monumental scale of this task, they have done reasonably well.
Yes, there is a shortage of vaccine. But the United States and other countries are facing similar problems, usually as a result of the difficulties with the painstaking process of manufacturing and testing the vaccine. Producers have to grow millions of copies of the virus in chicken eggs, then turn them into injectable form. In Canada, the situation was complicated by a decision to instruct producers to switch to manufacturing a form of the vaccine for pregnant women, then switch back to the version suitable for everyone else.
Authorities said the vaccine would be available beginning in the first week of November. In fact, they did slightly better, rolling out vaccinations for vulnerable groups last week. The lineups were a direct result of the death of Evan Frustaglio, the 13-year-old hockey player who succumbed to the illness last month. The much-publicized death of a healthy adolescent set off a wave of fear about H1N1 and sent people rushing to vaccination clinics.
Remember that just before that tragedy, polls were showing that a declining proportion of Canadians wanted to get the vaccination. Some were worried about its safety, others were simply concluding that the flu was not serious enough to warrant going to the trouble. The problem health officials faced was trying to persuade the public to get the shot. Now they find themselves urging patience on people who are suddenly eager for the shot but do not fall into one of the higher-risk groups.
Sending the right message is tough. Critics claim that authorities are contradicting themselves when they say that the illness is mild for most people, but that everyone should get the shot anyway. But that's exactly the message they send every flu season when they urge people to get a vaccination against seasonal flu as a precaution: most people will not get seriously ill, but just in case, get the shot.
Arlene King, Ontario's chief medical officer of health, reiterated yesterday that "in the vast majority of cases," people who get the H1N1 flu will recover on their own with no medical help. It's a message that health officials should keep driving home. Richard Schabas, Ontario's former health officer, notes that a child in Canada is 20 times more likely to die in a car accident than of H1N1 flu.
Fortunately, most people seem to be getting that message. Lineups at clinics such as the one at Metro Hall were much shorter Monday, as the panicky feeling of previous days waned. Rather than rant about the supposed failures of health officials, sensible people will calm down, weigh the risks and carry on.