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Writer responds to critic

Re: Peter Emery's letter: Learn to live with Covid (Castanet, Sept. 21)

Mr. Emery wrote: "If Mr. Buckna is concerned about mixed messaging regarding vaccinations, then he has certainly succeeded in adding to the confusion. He starts with his anti-conservative political statement and then references two movies based on a fictitious disease."

While the two movies (Outbreak and Contagion) focus on fictitious diseases, Emery failed to answer the question: "If COVID-19 or one of its variants displayed many of the same symptoms, do you really think there would be many anti-vaxxers and anti-maskers still talking about their rights?"

Megan Garber, staff writer at The Atlantic, wrote: "Outbreak gets a lot wrong, but it gets one of the broadest things right. It understands that, in America, one of the biggest threats to public health can be American culture itself." Garber contrasts the many explosions in the movie with the reality of the current pandemic: "One of the defining qualities of COVID-19, after all, is precisely its lack of explosive, surround-sound dramas. The virus resembles the flu. It is carried, sometimes, without revealing its presence through any physical symptoms at all. It is deadly in part because it seems so banal. It hides in plain sight."

When "Contagion" (2011) was released, the Centers for Disease Control and Prevention pointed out the movie has some accurate scientific content about viral outbreaks. Glenn Wortmann, head of infectious diseases at MedStar Washington Hospital Center in Washington, D.C., agreed: "The film presents a plausible series of events" based on what we know about how viruses can possibly jump from animals to humans.

Emery continued: "He [Buckna] questions what happened to 42 million rapid (or antigen) test kits. The likely explanation is that public health officials realized at a very early date that these tests are totally inaccurate. Worse still, they give negative results in many cases where the virus is present (in one set of tests it failed to identify the virus in 72% of people with symptoms, and only 58% of people without symptoms)."

Rapid tests are "totally inaccurate”? It appears Emery's reference to "one set of tests" was the March 2021 review of studies published by Cochrane, a global independent network. The review showed rapid antigen tests are better at correctly identifying cases of COVID-19 in people with symptoms than in people without symptoms.

Emery misrepresented the 72% figure. The review actually showed the opposite of what he claimed: Rapid tests correctly identified active infections in 72% of the people who were showing symptoms, on average. He failed to mention that the review showed large differences in the accuracy of different brands of test, with very few meeting the World Health Organization minimum acceptable performance standards. The Cochrane reviewers also pointed out there is some emerging evidence that the accuracy of the test is affected by who is doing it, and recommended future studies should look at the relationship between the experience of the person administering the test and the sensitivity of the test.

Dr. Michael Mina, an epidemiologist, assistant professor at Harvard School of Public Health, was interviewed Sept. 7 on MSNBC. He told host Chris Hayes: "The rapid tests are very accurate if your goal is to ask the question, am I infectious right now? And for that question, they're extremely accurate. ... They tell you, am I infectious right now? And if so, that means you should be isolating because you don't want to spread it to other people."

In my June 24/21 Castanet letter: Not at herd immunity yet, I quoted Colin Furness, an infection control epidemiologist and assistant professor at the Faculty of Information (University of Toronto): "Rapid tests do not produce false positives. They just don't, and anyone in public health who says they do -- and there are people saying that -- are just flat-out wrong. They don't know their domain. They don't know their material, and they're misleading." Point of clarification: When Furness said “Rapid tests do not produce false positives”, he did not mean can’t ever produce a false positive, but pretty close.

Emery continued: "Mr. Buckna praises (Prime Minister Justin) Trudeau in the first part of his letter but fails to condemn him for government failure to protect the occupants of long term care homes."

Is Emery not aware that the provincial and territorial governments are responsible for the management, organization and delivery of health care services for their residents, not the federal government? The federal government is responsible for setting and administering national standards for the health care system through the Canada Health Act, providing funding support for health care services.

During the campaign the Liberals, NDP and Greens advocated national standards for long-term care, but Conservatives and the Bloc pushed back, saying the federal government should stay out. The NDP and Greens both want to end the for-profit business model from long-term care altogether. The PPC platform did not include any specific measures on long-term care.

The Liberals promise $3 billion over five years, starting in 2022-23, to ensure provinces and territories provide a standard of care in their long-term care homes. They also promise another $6 billion – in addition to $4 billion in budget – to help provinces and territories clear health-care system backlogs and wait lists caused by the pandemic. Finally, they promise to work with provinces and territories to train up to 50,000 new personal support workers in long-term care facilities, and raise their wages to a minimum of $25 an hour.

Both Liberal and Conservative governments still deserve criticism for never making long-term care part of Medicare and the Canada Health Act.

According to Dr. Samir Sinha, director of health policy research and co-chair at the National Institute on Ageing, long-term care is "something that’s been underfunded significantly compared to our other OECD countries, so we spend 30% less on the provision of long-term care in Canada versus what other industrialized nations spend."

David Buckna, Kelowna



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