10 July 2022

Crime and no punishment: Public Health


When Leigh kindly invited me to write crime/mystery articles from a medical viewpoint, he certainly wasn’t expecting me to colour wildly, and enthusiastically, outside the lines of my mandate. Both he and Rob have been infinitely patient with me and I owe them an apology, because here I go again.

In my defence, crime can be seen through many lens: breaking the law, injustice and even awful things that happen.

I’ve been thinking a lot about awful things that are happening. They’re not a crimes in the sense of breaking a law. They do, however, result in death and, from a certain point of view, can be seen as murder. Mass murder.

What are these awful things?

Lousy Public Health decisions.

Public health is defined as the organized effort to keep people healthy and prevent injury, illness and premature death. This field was once relegated to textbooks, articles and conferences enthusiastically attended by nerds in the field.

What is this Public Health thing that most of us happily ignored for so long and why is it messing with our lives?

The reality is that Public Health has always messed with our lives. From the 1800s, the sanitary reform movement, spurred on by new understanding of disease transmission, helped create sewage treatment infrastructure alongside water filtration systems to provide clean drinking water. This sounds very technical, but imagine drinking water filled with feces and urine— it’s a great way to spread disease and, seriously, totally gross as well.

From food safety standards to policies for disease mitigation, from mass vaccination to public education, Public Health has been there for us. Before mass vaccination programs, diseases like smallpox, polio and diphtheria were rampant. Before changes in hygiene standards, your surgeon would operate with bare, unwashed hands and your food was prepared and served without hand washing too. Again – gross.

What seems self-evident now, was not always so. In fact, when the Canadian Public Health Association was created in 1910, the early founders were determined to bring about change, “come hell or high water.”

Sounds like fighting words to me and suggest that, even then, the pushback they faced was serious.

Fast forward to 2022 and we see many Public Health decisions move from the ‘hell or high water’ fight to a ‘paddling in leaky canoe and ignoring the tidal waves’ approach.

Harsh?

Hardly.

In my home province of Ontario, we have a surge in the new omicron variant, BA.5 and yet, public health has removed masks mandates, even for hospitals, allowing our most vulnerable patients to get infected. We have vaccines but anyone under 60 is being denied their fourth dose, despite the fact that third doses have long since waned for most people. Allowing BA.5 to infect our citizens by refusing to institute even the minimum of mask mandates or updating much needed vaccines is harsh and unethical. People will die. My statements are mild in comparison.

During COVID-19, decisions that endanger and kill people are being made not just in my backyard - they are being made all over the world.

Some will ask, “Isn’t this politics?” Yes. Of course it is. But here’s the rub: all of these decisions are presented to us by a M.D. who is the Chief Medical Officer. His M.D. gives him credibility – imagine how many would listen to him if he had a botany degree? So, these are Public Health decisions presented by a M.D. and this makes all the difference. If a doctor makes a decision knowing this will endanger or kill a patient, they can and should lose their licence. If a doctor makes a decision that endangers or kills many - give them a title of ‘medical officer of health’ and they have impunity.

Even a non-MD who makes a decision knowing others can be harmed or killed is held accountable - think of a driver who is drunk, drives a car and hits a pedestrian. We hold them accountable for the harm and death they cause. Crimes that can be legally prosecuted apparently are very different than awful things that happen to people. Mass harm and mass murder are O.K. if they are a ‘policy’ decision.

In 2020, I was concerned but optimistic. In 2021, I was worn out and somewhat discouraged. Now, I’ve reached the level of being sad and furious.

Awful things knowingly dumped upon us by Public Health should be crimes.

They are not.

And that is a crime.

5 comments:

  1. And yet the rate of Canadian deaths has been much lower than ours- showing what a real mess our neglected public health systems are.

    ReplyDelete
  2. Or maybe the political spin on COVID?

    ReplyDelete
    Replies
    1. Can you expand on what you mean? (The partial sentence isn't very clear.) Thanks.

      Delete
  3. The history of population health and medical discovery has been strange and convoluted. Trepan that skull, lobotomize your boy, drain that blood, eat off your own trencher but why wash it?

    Schei├če nicht wo du isst. One would think the smell might give citizens a clue, but instead they joked.

    We think of pollution and contamination being bad today, but anywhere humans gathered created a mess. My Aunt Rachel Kemper said in a lecture, "Civilization is the creation of a sewage problem."

    Mary, I rarely go out and when I do, I continue wearing a mask. I attended a large graduation ceremony Saturday and I was one of the very few at a potential super-spreader event. North America still has more than 2000 citizens a day dying.

    For the second time since this started, I ate out… and literally outdoors, which I like to think was safer. The good thing about Florida is you can find outdoor dining venues. The bad thing about Florida is an absolutely callous governor hellbent on promoting tourism at the expense of people dying. He isn't merely indifferent, he's aggressively anti-health measures. The coronavirus infected the political mind.

    So I for one welcome your article.

    I was glad to hear your thoughts that we'll eventually have an annual vaccination. No big deal, I get one for the flu. I along with many of our generation carry the penny-size upper arm scar (high inside the thigh for some girls to avoid a visible mark). Instead of a political thing, we were pleased to help stamp out smallpox and polio.

    Well done, Mary.

    ReplyDelete

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