H1N1 threat places heavy burden on health officials

Calling Gerry Delorme a giant would be stretching it.

Still, the province's director of disaster management looks almost big enough to carry the weight of a pandemic on his shoulders.

Which is what he's been doing for the last eight months.

Just before he and Dr. Joel Kettner walked into a news conference in a basement room of the Manitoba Legislative Building Wednesday, Delorme turned to the province's chief medical officer and put the pressure in personal perspective.

"This is way more complicated than a flood," Delorme told Kettner.

Just how complicated it is for Delorme and Kettner -- the men charged with protecting the lives of hundreds of thousands of Manitobans and deciding who goes to the front of the H1N1 vaccination line -- became even more evident to both of them this week.

Two Ontario kids, a boy 13 and a girl 10, died after contracting the H1N1 virus.

Teenagers and school-age children aren't considered high-risk groups to be immunized first as the vaccine is gradually doled out across the country.

The front of the line is reserved, instead, for the likes of smaller children, women who are pregnant, the medically compromised and, for a change, for aboriginals and the homeless, who are accustomed to being society's back-of-the-line people.

Health-care workers have been allowed to go to the front of the line, too. Rightly so, because of their exposure to the sick and the essential service they provide during a pandemic.

Although not all health-care workers are necessarily seen as equal.

The Winnipeg Regional Health Authority has acknowledged that late last week it initially overlooked family physicians and their front-line workers when announcing who would be among the first vaccinated.

It was an embarrassing admission for the WRHA which, on the whole, has planned well, especially with outreach programs for the homeless.

Perhaps the oversight with the family physicians has something to do with institutional myopia. Family physicians, unlike hospital doctors, aren't employed by the WRHA.

Whatever the reason for briefly forgetting the family docs, there's no good reason. Not after having months, if not years, to plan for the pandemic.

It makes one wonder what else the provincial and regional heath-care decision-makers might have got wrong and may have to correct.

Like not using schools to vaccinate school-age children, perhaps.

That seemed to be what the room full of reporters wanted to ask Kettner and Delorme.

Delorme, for his part, said the decision to use mass vaccination clinics rather than setting up shop in schools had to do with efficiency.

Efficiency for the system, perhaps, but what about the children and their parents?

Kettner suggested that the deaths of the two Ontario children notwithstanding, there is no evidence to suggest the tragedies are any more than isolated cases. Or that school-age children are a high-risk group.

"We're going to follow the program until we have enough evidence to change it," Kettner told the news conference.

Of course it's somewhat of a moot point because right now there isn't enough vaccine in Manitoba to do all school-age kids. And they're not a priority -- except with their parents.

Parents like Progressive Conservative Leader Hugh McFadyen, who wants the vaccination program in the schools.

I agree.

But it's not my responsibility to monitor the progress of a virus and make those complicated decisions.

It's people like Gerry Delorme and Joel Kettner who have to wonder, day to day, how bad will it be?

What's waiting round the corner?

And are they really ready for it?

After the news conference, when the rest of the reporters had hurried off to file their reports, I asked Kettner --who still works in the hospital front lines -- how he felt when he heard about the two Ontario kids who had died so unexpectedly and so swiftly.

This time he answered my question in a personal, more human way.

"You feel awful," Kettner said. "Have we got the wrong priority group? ... Are we on the right path?"

gordon.sinclair@freepress.mb.ca

Republished from the Winnipeg Free Press print edition October 29, 2009 A3