in today’s news

mask friends

Received kudos today from Isra Levy, the Medical Officer of Health, via a forwarded all-staff email. (He’s the guy that’s on all the press releases and evening news specials).

I feel proud of my colleagues and the Centre as a whole. It’s hard to quantify the amount of resources we are employing to divert 50-60 sick people/day from the emergency rooms – in many ways, we have shut down the Centre and are starting from scratch. While it is a sometimes inefficient system, and protocol is always changing, spirits are high and clients are receiving excellent care.

Day three feels more like week three, though I am enjoying the excitement. In tomorrow for a Saturday morning ILI show-down.

On the news @ 2:10 here.

now if you could just put this on

With a few dozen fewer clients than yesterday, day two was slow. Lots of media coverage of our opening day but all an exaggeration of next-to-no action. I feel reassured that this month has a purpose when I see a client leave with a box of tamiflu, though this doesn’t happen very often. Is it wrong (yes) to want a more exciting pandemic?

The N-95 masks are hell to wear and people are starting to switch to surgical masks. Surgical masks are all for show – they prevent you from infecting others, but are not particularly good at protecting you from infection. The gowns, however, are extremely fashionable despite being completely pointless, and we’re all thinking of how to work this gear into Halloween 2010.

The candy brought in for sick kids? It’s become a bit of an incentive to taking clinic shifts. I see lots of staff popping mini chocolate bars under their masks – how can something that feels so good be wrong? This has got me waiting to see if staff start to get sick and really hoping we don’t. Things are hectic enough as it is.

day one: the bug stops here

squeaky clean

A Community Health employee cleans the hand rails at the Sandy Hill Community Health centre which opened a flu assessment clinic to help reduce the pressures on emergency rooms in Ottawa yesterday. Health Minister Deb Matthews says Ontario will run out of the regular swine flu vaccine by the end of the week.

The first client to be assessed happened to be in the Centre for non-flu related reasons before the fun officiallly started, but was pulled into see a doctor by staff. He sat coughing by himself in the “contaminated” waiting room – the masks went on before the lights did. There were no long lines at the door, just a few regulars confused by the change in hours. One lonely coughing client and 30 people in infection control gowns and vinyl gloves. The beginning.

I worked the door for the afternoon, and was the first stop for all visitors, sick or not. Four staff to manage a client flow of maximum 2-3 people at a time. We had stickers to give the kids who fussed over the masks. The halloween candy was co-opted by staff looking for a midday snack.

No hitches to speak of, but the masks were met with some suspicion. What’s so scary about a mask? The mask became a symbol of disease, and many people wanted to distance themselves from the idea of a pandemic. “I’m just here to see my doctor” was a common excuse to try to slip by without being screened. Clients linked the vaccine to a world government conspiracy, and hand sanitizer was talked about as a corporate money grab that would weaken the flock. These themes came up often enough to be a trend. Lots of speculation about a dystopian future ”where one day we will all be wearing masks.” Just like Orwell said we would…

None of this mattered, though, because wearing a mask makes you feel brave enough to assert with absolute conviction that no one is coming in without a purel spritz. Simple! And as much as the mask is not a great look aesthetically, just put the darn thing and be pacified.

Our first day provided a very small number of nasty coughs and a very large number of concerned asymptomatics (mostly parents with children). In a real life way, there doesn’t need to be a flu assessment centre. The imagination of this flu far surpasses the ground-level viral effects. This whole exercise is to keep people who aren’t sick enough to need treatment from clogging hospital emergency rooms.

A common refrain: ”Does your child have a cough? Does your child have a fever? No? Then why are you bringing them the city’s locus of sick?”

Apart from having no idea how to properly take off my PPE (the scary masks, gowns and gloves) and likely contaminating myself, day one went a-ok.

in just under twelve hours

I am an interloping admin type with big ideas at a community health centre in Ottawa, Canada.

At the behest of the Public Health Department, our Centre will transform indefinitely into a Flu Assessment hub starting tomorrow morning. No one is really sure what this means yet. We’ve ordered a parking lot-sized tent and put hand sanitizer on every level surface. Other than that, things are up in the air.

Our duties for the next two weeks are mapped out on a rainbow of poster paper – no pushing now, we do things by consensus here. I’ve signed up for as many shifts as possible outside the office and inside the whirlwind that may or may not follow a mass campaign directing an entire mid-sized Canadian city to one of 6 sites, including my very own CHC.

Has the country run out of vaccine? Is everyone going to get sick? Will business grind to a halt? What’s worse: H1N1 the flu, or the pre-Christmas news lull that has created a paralyzing media frenzy out of something so simple as a little piglet tickle? And for my part, what is this all going to look like from the front of the line?

I am curious to see how the next few weeks unfold. We live in a brave new world. This is our first shot at a modern-day, developed nation-style pandemic face-off. And this stuff is interesting – is the public health breakfast machine going to pop out a shiny solution to the paradox of healthy people getting really, truly sick? How the heck did we push this pandemic off for so long, and what is it going to look like if and when it really gets rolling?

Are we ready?

3… 2…

Dunno! But let’s find out.



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