Leveraging all we've got in the COVID fight

February 7, 2021

Dr. Paul Boucher, AMA President

Dear Members:

Efficiently vaccinating Albertans against COVID-19 will be a monumental task that will only be accomplished with careful planning and intersectoral collaboration. In my January 28 President’s Letter, I shared with you some imperatives I see for success. I also provided you with a letter that I wrote to the Minister (member login required), asking to open a conversation about making this process work for Albertans. He has responded, resulting in a joint statement from Alberta Health and the AMA, and a commitment for partnership to advance COVID-19 vaccination. 

As physicians, our first priority is to talk with our patients, families and neighbors about the vaccines and why it’s so important that everyone afford themselves of this protection if they can. We know that vaccine hesitancy is an issue for some, and physicians have a significant role to play in education and battling misinformation. Consistent messages from all stakeholders will be key to creating trust with the public.

To help us get the job done, the AMA is pleased to announce the launch of the “Be a Vaccine Positive Clinic” toolkit. Our thanks go to the Alberta College of Family Physicians, Alberta Health, Alberta Health Services and the College of Physicians & Surgeons of Alberta for their tremendous assistance with this project. This toolkit will equip you to talk with patients about the COVID vaccination. It was created with guidance from physician leaders to ensure the information and resources are particularly relevant for physicians and clinic staff.

I realize that much of the public conversation about vaccines has been about supply challenges, but we need to look ahead to the time when there is more vaccine than current capacity would allow us to administer. Collaboration will be crucial to succeed in the massive logistical and public health challenge involved. We need to begin by leveraging the existing resources that all stakeholders can bring to bear and look to creating new infrastructure where it makes sense to do so. As the joint statement notes, community physicians will be involved in the rollout. While not every community practice will be in a position to assist, we need to engage those that have that capacity today and explore options to expand where we can. We are engaging with leaders in community medicine and look forward to working with government and others.

This is the time to use our respective strengths and resources so that Albertans can receive the vaccine as quickly, safely and easily as possible. There are other questions to answer still, including how health team members themselves will fit into the rollout. Protecting our community medical infrastructure is key for the health of all Albertans. I am confident that with the collaboration of all the parties, these matters will be addressed in a timely fashion.

I want to thank Minister Shandro for responding to the offer of support from the AMA. I look forward to what can be accomplished and, as always, I will keep you informed.

In case you missed them...

On January 28, the AMA experienced some technical issues such that not all members received a number of publications sent that day. Just in case you missed them, here is a list and links to the pages on the website:

Your comments are welcome in the following ways:

  • Communicate with me privately and directly by email if you would like a reply: president@albertadoctors.org  
  • Comment publicly on this President’s Letter on the AMA website (please be aware that comments are public, i.e., not members-only, even if you are logged in as a member). 

Sincerely,

Paul E. Boucher, MD, FRCPC
President, Alberta Medical Association

1 comment

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  • #1

    Peter L Chiu

    Physician

    12:03 AM on February 22, 2021

    I commend the efforts and priority our government and public health leaders placed on vaccinating residents and staff at nursing homes and senior care facilities in Alberta. The rationale is that mortality rate among these residents, once infected by covid, is extremely high. Hence the staff and health care workers caring for these residents should be prioritized for covid vaccinations to reduce risk of covid outbreaks in these facilities. In reviewing recent literature published from around the world, as supported by the following references, the mortality rate among cancer patients, if infected by covid, is alarmingly high. A prospective cohort study from the UK (ref 1) published in the Lancet in 2020, among 800 patients with cancer infected by covid, mortality rate was 28%. Another study from the USA published in the Lancet in 2021 (ref 2), cancer patients who required haematopoietic stem-cell transplantation (such as the in-patients in WW Cross Cancer Institute), among 318 patients who were infected by covid, the mortality was 32%. An international cooperative study from around the world in Europe and North America, published in the journal Blood in December of 2020 (ref 3), among 650 patients with multiple myeloma, a form of blood cells cancer which is treated at the WW Cross Cancer Institute, the mortality rate was 33% when they were infected by covid. These recent statistics raised the urgent alarm that if there is a covid outbreak at the WW Cross Cancer Institute, what degree of catastrophe tragedy and outcome would ensue? Besides high mortality as abysmal as the nursing homes statistics, the lack of cancer care experts and their supporting staff due to quarantine requirements will throw the standard of cancer care in Edmonton and Northern Alberta out the window. Now that there is improved supply of covid vaccines in Alberta, this urgent issue needs to be addressed as soon as possible by the Alberta government as well as decision makers in Alberta Public Health. ref 1 Lee L et al Covid-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study. Lancet 2020: 395:1919-26 ref 2: Sharma A et al Clinical characteristics and outcomes of covid-19 in haematopoietic stem-cell transplantation recipients: an observational cohort study. Lancet Haematolo published on line January 19, 2021; ref 3: Chari A et al. Clinical features associated with covid-19 outcome in multiple myeloma: first results from the International Myeloma Society data set. Blood Dec 24, 2020. Vol 136, number 26 p 3033-3040. respectfully submitted by Peter Chiu MD FRCP (C) Clinical assistant professor of Medicine, U of Alberta

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