Over the past two weeks, we’ve learned a lot of truly unsettling lessons about the ability of our public health system to cope with a widespread disaster. As thousands of Canadians converge on the H1N1 vaccination clinics scattered thinly across the country, most are running into huge lines and bureaucratic confusion. These are the most vulnerable groups — mostly health-care workers, children and pregnant moms — waiting for hours among the sniffling masses, worried that the next person who forgets to sneeze into their sleeve will be passing along a fatal bug to their loved ones.
It’s clear now that health officials were so obsessed with their marketing efforts, and convincing the public that they needed to get the shot, that they failed to adequately prepare their distribution strategy. It’s a classic business administration error, only this one comes with potentially devastating consequences.
In the wake of the tragic deaths of Evan Frustaglio, 13, and 10-year-old Vanetia Warner in Ontario, Canadians are now rightly convinced that H1N1 represents a serious threat. Health officials warned us for weeks that anyone who failed to get the shot wasn’t just taking an unwise risk, they were irresponsibly putting others in peril. We were told repeatedly that the biggest and best-planned mass vaccination effort in Canadian history was ready. And yet, when the day came to finally get the shot, Canadians discovered a system that is horribly, maddeningly inadequate to meet the demand that government itself built up.
In the first week that the vaccine was available, people in southern Ontario faced four-to-six hour wait times, and several clinics closed within 90 minutes of opening because they were overwhelmed. The exact same scene is playing out across the country. In Toronto this week, there are 10 clinics to serve a population of more than 2.5 million. They are open seven hours a day from Monday to Saturday, and closed on Sunday. In Calgary, just four clinics were initially set up to service a city of more than a million people. Does that sound like the kind of schedule designed to address a potentially deadly health crisis that threatens to overrun our hospitals? Dr. Tom Noseworthy, director of the Centre for Health and Policy Studies at the University of Calgary, called Alberta’s response an “embarrassment” that showed a “horrific lack of planning,” and it’s impossible to argue with that.
Now there are reports that we will soon will soon face countrywide shortages of the vaccine itself, even after officials insisted they had an adequate supply.
The situation is analogous to a high-profile product launch, where marketing efforts must be matched by detailed plans for distribution, supply chain management and service. When a business creates more demand than it can supply, it can sometimes yield benefits, creating a consumer frenzy around a new product. Needless to say, the stakes are infinitely higher when it comes to public health. This is not a matter of disappointing a few people hoping to have an iPhone or a Tickle Me Elmo in time for Christmas. This is a dangerous flu, and a public frenzy is exactly what we’re supposed to be trying to avoid. Government had close to a year to prepare for this, and yet officials seem surprised to discover so many people asking for the shot. What if this strain were even more virulent than it is?
When a company fails to match its marketing plans to its distribution system, it runs the risk of angering customers, losing sales and hurting credibility. Executives can see their careers stalled. Some are even forced to resign. When public health officials fail, the risks are far more serious and potentially deadly. Clearly, the consequences for such a monumental failure ought to be as severe in government as they are in private enterprise.
