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Apr 12, 2022Liked by Linda Pannozzo

Excellent work Linda! We are so lucky to have at least one journalist here not afraid to ask important questions and honestly seek the truth. Unfortunately the fourth estate is now owned, controlled and used by the destructive forces of neoliberalism. Hopefully other journalists and editors will be inspired and emboldened by your work!

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Apr 9, 2022Liked by Linda Pannozzo

Excellent and fascinating article Linda. Covid 19 has been a very convenient scapegoat for the depredations of neoliberalism and government/corporate malfeasance, and like every crisis, has been exploited to accelerate the process, further shift resources and power upwards, and further attenuate our fragile democracies. The gutting of regulatory agencies has been a critical element of this process so that the institutions most involved in pandemic response, like the pharmaceutical industry, is a major funder of these agencies and is virtually self-regulating. What that means for the safety and efficacy of its vaccines is just starting to trickle out now thanks to a federal judge in the US ordering the release of Pfizer’s suppressed trial data, and the picture is not pretty. The systematic suppression of effective, potentially life-saving treatments is another part of this sordid story with a death toll that will never be calculated. Meanwhile private ownership and perfunctory monitoring of already sub-human standards of care at LTC facilities transformed many of these institutions into pandemic torture chambers where society’s most vulnerable were subjected to unspeakable suffering and indignity at the end of their lives. And how many of the metal health hospital admissions and diseases of addiction are a result of people trying to cope with the psychological stresses of poverty and isolation which are predictable results of neoliberal policies, stresses massively exacerbated by pandemic restrictions. In all these instances a biological virus is being used to hide the epic injustice and criminality of an ideological/economic virus that is overwhelming the immune system of our democracies and destroying the planet’s own life systems. Unless we develop resistance to *that* disease, which you have accurately identified and of which our over-capacity hospitals are one symptom of many, it will make Covid 19 look like a walk in the park.

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Good questions. I had not had much to do with the NS health care system until my elderly neighbours were in very tough shape. I spent much of my time that spring caring for them while they waited for home care, or to be admitted to some kind of care facility. They were something like 80th on a list then moved to 60th. They couldn't get into a care facility together -- he could get into one for veterans at some distance - I think at Truro - but she couldn't live there (she was severely disabled. This went on for many weeks. EMTs had to come out a couple of times. I was pretty frazzled by the time he passed away and she was finally admitted to a hospital. At the time, I was told that the hospitals had a lot of very elderly patients who should be in long term care facilities (the kind with advanced medical care), but there aren't adequate spaces and that causes a lot of the issues. Anyhow, that was my introduction to how stressed out the system in here in NS. The next summer, my mother had to be hospitalized in Ontario. She had a really rare and deadly autoimmune disease -- something they only see at the Ottawa General a few times a year. I don't want to compare apples to oranges, but the care was so advanced that it's probably too advanced. They throw everything they've got to fight any illness when perhaps they shouldn't. That said, it's like a finely tuned machine -- but they are bursting at the seams as well. Personally, after being primary caregiver for my husband, dad and mom through terminal illnesses, where things are really not working well is in handling palliative care. There don't seem to be enough palliative care facilities around and so terminal patients keep ending up transported to hospitals by ambulance, are in the ERs and ICUs for days, then in beds being cared for in ways that could probably be done at a palliative care facility if there was skilled nursing and also more doctors on call in those facilities. Also, palliative care could be done in home if the nursing was better and doctors could make house calls. I just know that a lot of the times when all of the people I cared for were hospitalized, they could just as well have been in a less high-tech facility, or at home, had we had more access to a different type of system. I think hospitals are a really poor place to provide palliative care, but unfortunately, a lot of people are spending their final days or weeks in them and it's not good for them and not good for their families. If I were King, I would change everything!!! :)

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Your stories reminded me of when my father was sick with prostate cancer back in 1993-1994. At the time it had spread to his bones and doctors were just trying to manage the pain. They never really got that right -- he was almost always in pain -- but he had a wonderful palliative care doctor who used to come to my parents' home. My dad was very connected to this doctor -- and his spirits were always lifted when this doctor paid a visit. I'll never forget how he really boosted my dad's quality of life. But when my dad's pain got to be too much, he had to be moved to the hospital and because of the rules governing that system, the palliative care doctor my father had grown so fond of was not allowed to be his doctor anymore. He was assigned another palliative doctor and I think my dad was heartbroken. I certainly was. The system didn't quite function with the wellbeing of patients in mind. Maybe these sorts of things have improved. I hope so. But I agree with you -- if they could have better managed his pain and if there was more specialized home care available, his end of life would have been enormously better.

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That's pretty much what happened with my father. Actually, the system has been a let down with all of the people I've cared for. I've actually read essays by a couple of doctors who had terminal illnesses and explained how the system isn't really set up very well from the point onward from when you stop treating an illness and move on to comfort care. I think a lot of it has to do with expectations that doctors should keep on trying and not give up and that there is always something else to try. I've seen first hand how that isn't the case and how we need to rethink how we do "end of life" care. I guess the thing I have noticed is that we are using precious resources to provide care that actually isn't helping and, in many cases, is not very good for the patient or the family. I'm not advocating for hospitals to give up on people, but just that, in a lot of cases, I think we could be giving even better care and pain management in a different setting. Dragging people who are in serious pain, back and forth to hospital ERs and so on - it just isn't right. We need to find a better way.

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So many journalist have not come forward during Covid, this concerns me as an RN who came out of retirement to work the covid response in March 2020 and got dumped 20 months later-no jab , no job, even applied for religious exemption- now almost 3 years latter still not permitted to work, did anyone get an exemption? Anyway thank you for your work

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Thanks for your comment, and for your dedication. From what I've been able gather, there were some exemptions, but very few. The criteria was extremely tight, and I don't believe any exemptions were given for religion or conscience reasons. Take a look at a later piece titled "Breaking Ranks," which looks at some of the issues around vaccine mandates for workers in "high risk" settings.

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Apr 9, 2022Liked by Linda Pannozzo

Thank you, Linda. Invaluable journalism!

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Thank you, Joan.

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This was a very thoughtful and interesting read. I wonder if the stats you have provided are similar across Canada...

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That is a very good question Terry, and one I can't really answer. But I would say the trends toward less spending on health care and fewer hospital beds would be consistent across the provinces and territories. COVID hospitalization numbers -- which can be fairly easily accessed -- would be quite a bit higher in most other provinces, but to see how they compare to other causes of hospitalization we'd likely need to submit FOI request in each jurisdiction, as was done here. Capacity rates and beds occupied would also be information needed at the provincial/ territorial level.

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I know that in our small hospital we have people in hospital beds who are waiting for space in our long term care home/assisted living home which created a problem finding beds for people who really needed hospital care. I'm sure that this is not just a problem for our small community.

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Thanks Linda! Seems to me that there's too great a focus on the health of the Health Care System, and not enough on the people who pay for it to be there when they need it. I remember my BS meter going off in March 2020 with the "2 weeks to flatten the curve" messaging being introduced. The whole point, we all learned, was to protect the (mismanaged to the point of collapse) system from becoming overwhelmed! That's what the system is there for! To protect the people who pay for it when they need it.

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Yes, it occurred to me at the time as well that the "flatten the curve" messaging was aimed at protecting a system that should have been there to protect us!

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Early on during covid, i searched around for info on how many ICU beds there are in all of NS (not very many), and thought, well, we're going to be screwed if it gets anywhere near as bad as it is in Washington, Michigan or NYS where I have many friends, some of whom work in the medical system. I'm sure that those at the top here in NS were probably in panic-mode to put the brakes on covid as they knew the system here would not be able to deal with the kinds of numbers being seen in parts of the U.S. Friends in more remote areas of the U.S. - such as friends in Wyoming, the Dakotas, etc.. said their little hospitals were filled up almost immediately. I think hospitals everywhere in North America are running at close to full capacity and were already having staffing shortages. Friends in the U.S. who have cancer have been dealing with scary delays for surgery, etc.. Sadly, I think a lot of this just has to do with population growth. The population of just about every city is exploding and we also have a pretty large aging population who may not have utilized much health care for most of their lives, but are now very much in need. Just watching the steady influx of retirees from elsewhere in Canada who are buying properties here in the Annapolis Valley gives me the shivers for what's ahead for all of us.

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For sure there is population growth and there is an aging population -- so for both reasons more money should be invested in health care, not less. As I mention in the piece, since 2000, per capita spending on public health care has stagnated in real terms. Let's also not forget that under the radar there's been a growing private health care system... we don't hear very much about it, but that is also playing a role here.

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Yes, I fully agree - and cutbacks or stagnation in health care funding take a long time to "fix". I'm from Ontario, so lived through the Mike Harris years and the damage that inflicted on health care and now it seems that the Ford government has done the same. Some people like to think that privatized health care is the answer, but based on what I've seen with american friends who are either doctors, nurses, or have serious chronic health issues (cancer, ABPA, etc..) the system down there is even more broken than ours. Rather frightening. All I keep thinking to myself is, "Don't ever get sick."

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