Showing posts with label COVID-19. Show all posts
Showing posts with label COVID-19. Show all posts

Monday, May 31, 2021

Bad Moon Rising (Musings on being fired for having 'long haul' COVID-19)

Updated: 31 May 2021

INTRODUCTION

The idea for the blog was stimulated by news of an American clinical laboratory scientist being fired after she had been infected with COVID-19 and was recovering from 'long haul' COVID-19, even though she had worked for  the employer (Community Hospitals of Central California) for 33 years. The news item came about because she has sued the employer for wrongful dismissal.(Further Reading)

The blog's title derives from a 1969 song by Creedence Clearwater Revival.

PERSONAL ANECDOTES

First, please note that I had a minor disability (suffered from acute lower back pain attacks) when I first joined UAlberta's Medical Laboratory Science first as a lecturer and clinical instructor for the hospital's transfusion service and later became an assistant professor. Was a candidate for surgery but the Drs decided to treat it conservatively, for which I'm grateful. 

The attacks were severe and my colleagues kindly would pick me up and drive me to work. I managed with a 2-wheel folding walker, and by taking mega doses of the pain killer ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID).

The university's Faculty of Medicine/Department of Laboratory Medicine and Pathology always supported me, even when I had to take extended time off. What they did was designate a hematopathologist resident to give my classes until I could return. One who helped is now in a senior position.

NOTE: If you've read this blog before you will know I'm a contrarian.

Over 36 years working as a medical laboratory technologist and educator, I've seen only two medical lab technologists who ever faced being fired

#1. One was when I worked at Canada's then blood supplier (Canadian Red Cross Blood Transfusion Service, also a transfusion service for the entire city) in Winnipeg. It failed. A compulsory Dr. exam was needed after you were hired, and the Dr. said a girl with deformed hands due to a medical condition could not perform her duties, as we then largely worked manually, did a lot of pipetting by hand. Staff saw she could do the work and I decided to get every lab worker to sign a petition saying she could do the work. She wasn't fired and went on to work many years for the organization, including becoming a supervisor.

#2. The second I heard about as an educator and it disturbed me. I've decided not to give many details to respect her privacy. I knew her well when she worked in a hospital transfusion service and was helping her get her ART (Advanced Registered Technologist), then offered by the CSMLSAfter losing her license to practice as a med lab technologist she became a medical lab aide and to me didn't deserve her fate. I wish I had been able to help her at the time.

SUMMARY

I've read several news items about the story and also the lawsuit , which is available online. What follows is my interpretation of the basic facts of the case. Yours may be different. Most is from the lawsuit, some from news items. The Plaintiff asked for a jury trial.

1. Plaintiff began working for Defendant, Employer, on or about 1 July 1987 as Clinical Lab Scientist. She received good performance reviews and salary increases and was not subject to discipline for her job performance over the more than 30 years of her employment.

2. Plaintiff suffers from several medical conditions including diabetes, cardio-pulmonary disease and traumatic brain injury. Defendant, Employer, is aware of Plaintiff’s medical conditions.

On several occasions when Plaintiff had to take time off work due to illness, Defendant, Employer, subjected her to discipline based on her attendance.

3. In mid-April Plaintiff contracted COVID-19. Her health care provider put her on medical leave for about six weeks.

4. Plaintiff’s health care provider suggested that she request intermittent medical leave due to her continued illness combined with her underlying medical conditions. Plaintiff requested the appropriate paperwork from Defendant, Employer’s leave of absence department. However, Plaintiff’s supervisor told her “you better not” referring to Plaintiff’s request for leave. In addition to this threat from her supervisor, Plaintiff was shunned by her supervisor and coworkers.

5. Within the year last past, without excuse, justification or privilege, agents of Defendant, Employer, including but not limited to supervisor Carol Kelley, published and republished, orally and in writing to third persons, including prospective employers of Plaintiff and other persons who are not parties to this action, the false and defamatory statements about Plaintiff, stating as matters of fact that, among other things: Plaintiff violated company policies; and Plaintiff deserved to be terminated.

My comment: Wow, they spoke to prospective employers and under which circumstances? My experience in Alberta, Canada is when FOIP (Freedom of Information and Protection of Privacy) became law, prospective employers who were not listed in an applicant's application for employment, would not comment except to say the person worked there. 

6. The Causes for Action in the lawsuit, which all relate to violations of  Government Code §12940:

1) Discrimination Based on Medical Condition, Disability and/or Perceived Disability in Violation of ...

2) Failure to Accommodate Disability in Violation of ...

3) Failure to Engage in a Timely, Good Faith, Interactive Process To Determine Effective Reasonable in Violation of ...

“It shall be an unlawful employment practice . . . For an employer. . . to fail engage in timely, good faith, interactive process with the employee . . . to determine effective reasonable accommodations . . .”

Defendant, Employer, knew of Plaintiff’s medical condition and her need for accommodation which consisted of additional medical leave. Yet, Defendant, Employer, failed to accommodate Plaintiff and ignored her requests for accommodation. Defendant, Employer, refused to explore any options to accommodate Plaintiff but, instead, subjected her to unjust discipline and terminated her employment. Accommodation of Plaintiff would not have caused Defendant, Employer, any undue hardship, significant difficulty or expense.

4) Failure to Prevent Discrimination and Discrimination Based on Medical Condition, Disability and/or Perceived Disability in Violation of...

5) Retaliation for Requesting Accommodation in Violation of...

6) Retaliation for Exercising Rights Under California Family Rights Act in Violation of 2 C.C.R. §11094

7) Wrongful Termination in Violation of Public Policy

8) Defamation

Within the year last past, without excuse, justification or privilege, agents of Defendant, Employer, including but not limited to Carol Kelley, published and republished, orally and in writing to third persons, including prospective employers of Plaintiff and other persons who are not parties to this action, the false and defamatory statements about Plaintiff, stating as matters of fact that, among other things: Plaintiff violated company policies; and Plaintiff deserved to be terminated.

The statements made by Defendants and their agents were and are false and constitute defamation on their face in that they communicate to third persons as matters of fact that Plaintiff was a problematic and poorly performing employee who deserved to be terminated from her job. This constitutes defamation per se as false statements tending to injure Plaintiff in her profession.

Plaintiff asks for the following:

  1. For general damages in excess of the jurisdictional minimum of this Court, according to proof;
  2. For special damages according to proof;
  3. For exemplary punitive damages, according to proof;
  4. For interest on the amount of losses incurred in earnings, deferred compensation and other employee benefits at the prevailing rate;
  5. For reinstatement to her job with Defendant, Employer;
  6. For costs of suit, including reasonable attorneys’ fees; and
  7.  For such other and further relief as the Court may deem just and proper.

FOR FUN

Had difficulty choosing a song for this blog but settled on the following, as I wonder how many 'long  haul' COVID-19 folks will suffer a similar fate of the med technologist in this blog. 

I see the bad moon a-rising / I see trouble on the way...

FURTHER READING

  1. Hospital-based clinical laboratory scientist is suing her former employer after being fired due to long-haul COVID-19 illness (5 May 2021)

Thursday, April 01, 2021

Simply the best (Musing on healthcare educators during COVID-19)

INTRODUCTION
I've meant to write this blog for awhile. I'm privileged to look after the mailing lists for University of Alberta's Medical Laboratory Science. As such, even though I no longer teach in the division, I get all messages to students and staff plus more. The blog will focus on medical laboratory education but I suspect it rings true for other health professionals. Had help with ideas for the blog from a former student of mine, who I won't identify at this time.

The blog's title is based on a ditty written by Holly Knight and Mike Chapman, but best known by Tina Turner's recording of it.

HOW EDUCATORS  ADAPTED DURING PANDEMIC
Where to start. I'll need to speak in generalities because it differs depending on the prevalence of COVID-19 in educators' areas. Sample list of key adaptations heath profession educators had to make:
1. Managing the chaos of ever-changing information. Suspect most people know how hard this is as regulations and policies regularly change as new evidence becomes available. Good example is the changing advice on the AstraZeneca COVID-19 vaccine as research and real world evidence become available.

2. Online learning. This was a major transition, involving putting course material online. Much harder for instructors who didn't use Powerpoints regularly, instead had in-class activities. 
Not all students enjoy online learning as much as face-to-face interaction with classmates and instructors, nor do the assignments, required pre-reading, etc. That's true for in person classes too but worse with online learning. Plus it's much easier to be distracted when text messages arrive as today's students pretty much have their cell phones on at all times.

Online learning also put much stress on university, community college, and technical institute IT departments.

3. In introductory courses, depending on when the pandemic was declared, students had a different laboratory experience than in prior years when all routine labs and a final exam were performed before entering the clinical year. Similarly, for other pre-clinical experiences such as phlebotomy visits to outpatient labs, etc.

Ultimately, some in-person introductory lab courses resumed, but required many adaptations in student labs. Examples: Fewer students in each lab space (e.g., one lab becomes two), shower curtains erected for students facing each other on the same bench, between labs sanitizing high touch areas (door knobs, bench areas, reagent bottles).

4. In the clinical year, depending on when the pandemic was declared, students were pulled from the sites until safety precautions could be put in place. This required re-scheduling.

5. Depending on how many institutions, healthcare organizations are involved, processes and procedures could differ, requiring educators to meet the needs of each.

LEARNING POINT
To me all healthcare educators deserve a loud round of applause for how they've had to adapt during the COVID-19 pandemic to constantly changing regulations and policies. In some ways I'm glad I retired decades ago as I would have found this difficult even then.

FOR FUN
Chose this song because to me healthcare educators have been simply the best during COVID-19 pandemic. To me they're heroes similar to those on the frontlines.
As always, comments are most welcome (you can do so anonymously or by name below) and  there are some.

Sunday, February 28, 2021

I will remember you (Musings on healthcare heroes during COVID-19 pandemic)

 Updated: 1 March 2021

February's blog is about healthcare workers who have been infected and died from COVID-19 worldwide, and who have made many sacrifices for us all.

INTRODUCTION
The idea for the blog was stimulated by  a series of news items posted in TraQ's Feb. newsletter (Further Reading). Also by the fact that so many healthcare professionals have put their duty to patients above the safety of themselves and their families. COVID has also highlighted invisible health professionals such as medical laboratory technologists/biomedical scientists who have shone with dedicated work to test for COVID-19 infection. Plus
Emergency Medical Services (EMS) emergency medical technicians Also those who work for low wages in long term care facilities, often immigrants who need several jobs to make a go of it, and  personal care workers. 

I could also focus on many non-healthcare heroic workers during the COVID-19 pandemic. If I've missed any, please send a comment. Examples (Some in Further Reading):
  • Hospital cleaners and maintenance staff
  • Daycare workers
  • Teachers, teachers' aides, school janitors
  • Apartment housekeeping & maintenance staff
  • Meat plant workers (often immigrants) who are often housed in close contact with other workers
  • Grocery and food retail workers
  • Food delivery drivers
  • NEW: Transit workers who transport essential workers to and from work (Thanks, Penny)
The blog's title derives from a 1995 Sarah McLachlan song.

THE EVIDENCE
Folks, there is overwhelming evidence that health professionals and many others have stepped up to the plate during the coronavirus pandemic. I do not need to belabour the point. The aim of this blog is to celebrate their contributions around the globe at great personal cost to themselves not just dying but also anxiety and depression.
  • While the numbers of those dead due to COVID-19 are overwhelming, it's key to remember that each of these folks are individuals, someone's 'significant other', child, mother, father, brother, sister, aunt, uncle, cousin, friend. 
  • As of 12:39 pm Central European Time, 1 March 2021, there have been 113,695,296 confirmed cases of COVID-19, including 2,526,007 deaths, reported to WHO. (Further Reading) 
  • See stories of some folks who have died from COVID-19 (Further Reading)
  • Note that people of colour are more likely to get COVID-19. (Further Reading)  
I encourage you read the items in Further Reading to gain a perspective on what we owe these heroes. Also to see affected people as individuals.

As always, comments are most welcome and there are some below.

FOR FUN
Chose this song because I hope we will all remember the heroes who put their lives at risk during the COVID-19 pandemic. I certainly will, as my husband with a serious lung disease went to the Emergency Dept. by ambulance in Dec. 2020 & spent a week in hospital.
FURTHER READING

Tuesday, June 30, 2020

You never give me your money (Musings on paying to develop COVID-19 vaccine)

Updated: 1 July 2020
What to blog about when COVID-19 dominates the news, whether it's research funding, impact on blood supplies, paid plasma proponents, testing, treatments, vaccines? Plus, of course, government guidelines and measures to prevent the spread of coronavirus while opening up the economy.

Finally decided that June's blog should discuss the question of who pays to develop COVID-19 vaccine and who gets priority once it exists, including which countries worldwide and, within countries like the USA without universal healthcare, will all be able to afford it.

The blog's title derives from a 1969 ditty by the Beatles.

INTRODUCTION
Governments worldwide have invested billions into developing a coronavirus vaccine, some given to university researchers, some to Big Pharma. There are reports that if a vaccine is developed inside a nation, that country will have priority access to the vaccine.

If COVID-19 has taught us anything it's that supply chains for crucial medical equipment like food, PPE and drugs must be secured and the best way is to produce them in the country, if possible. There are even reports of France and Germany accusing USA of diverting medical supplies like masks and that president Trump asked mask maker 3M not to supply masks and more to Canada and Latin America. Trump also bought up almost all stocks of Remdesivir, a drug used to treat coronavirus. (Further Reading)

Plus the world is experiencing infighting and global politics at its worst:
At G20 meeting of health ministers the intent was to strengthen WHO's mandate to coordinate fight against COVID-19 with a major focus on the process of crafting international agreements on any drugs or vaccines that successfully treat COVID-19. U.S. was the only country opposed to a statement that offered a framework for a united approach to fighting the pandemic and stopped funding WHO. (Further Reading)

HISTORY
The past has shown that poor developing nations don't have access to drugs that we in the industrialized world take for granted. Examples:

For the vast majority of the 325 million people living with hepatitis B or C, accessing testing and treatment remains beyond reach (Further Reading).
Without charitable donations by Big Pharma, for ages more than 75% of folks in developing world with hemophilia had little or no access to diagnosis and treatment. Those with severe hemophilia often did not survive to adulthood or, if they did, faced a life of severe disability and chronic pain (Further Reading).
Learning Points: If history repeats itself, COVID-19 will follow similar path. Folks in poor nations will be last to get the vaccine and treatments. And nations like USA whose POTUS puts America first, will try to gobble up most, leading to worldwide inequality in life-saving treatments. All at a time when the world needs to come together to fight a pandemic. 

As always, comments are most welcome and there are some.

FOR FUN
First song I chose for the blog:

Back-up song you may enjoy is 'Money' from 1972's Cabaret film.
  • Money (by Lisa Minneli & Joel Grey)
FURTHER READING
Listed by date of news report

Trump buys up almost all stocks of Remdesivir, a drug used to treat coronavirus (1 July 2020)


Big pharma is taking big money from U.S. taxpayers to find a coronavirus vaccine  and charge whatever they want for it (24 June 2020)

Will coronavirus pandemic change Big Pharma's long-term focus? (15 June 2020)

Sanofi and Sobi donate up to 500 million additional IUs of clotting factor to WFH Humanitarian Aid Program (14 June 2020)

U.S. must stop blocking global effort to fight COVID-19 (23 Apr. 2020)

Big Pharma wants billions more for COVID-19 funding pot (21 Apr. 2020)

German, French officials accuse U.S. of diverting supplies (4 Apr. 2020)

WHO urges countries to invest in eliminating hepatitis (26 July 2019)

Sunday, May 31, 2020

For the times they are a-changing (Musings on COVID-19 global news)

Stay tuned: Revisions are sure to come
What to write about during COVID-19? It initially stumped me. Possibilities I considered include how coronavirus has impacted the blood supply worldwide and increased pressure from paid plasma advocates to promote paying for all plasma and other body tissues. 

Finally settled on a mini-survey of coronavirus news featured in May's TraQ's newsletter to see what, if anything, that might reveal..

The blog's title is based on a 1965 ditty by Bob Dylan, and yes, it can be read many ways given the news.

INTRODUCTION
The mini-survey is based on news items I selectively collated for TraQ's newsletter during March, April, and May 2020. As past blogs will show, the blogs are mine alone and reflect my personal biases. 

For May's blog I arbitrarily organized COVID-19 news items into four topics, which have some overlap:
  • General (Information, industry news, search for treatments and vaccines)
  • Blood supply (Risk of shortages)
  • Convalescent plasma
  • Journal articles
SUMMARY 
Results of TraQ's March to May survey:
TOPIC 
MAR.
APR.
APR.
TOTAL
General 
0
13
8
21
Blood supply
6 3 4 13
Convalescent plasma
6 14 7 27
Journal articles
0 23 1538

Limitations
I could have calculated results incorrectly. My search alerts may not have identified all possible news items in each category. Also, in May the number of convalescent plasma news items soared and I decided not to include  many in the newsletter, as they often involved only a few people and were repetitive of earlier news. It's possible I haven't yet been alerted to the existence of more COVID-19 research articles published in May. 

LEARNING POINTS
So, as I recall from the 1966 film Alfie, it's time to ask, 'What's it all about Alfie?' Or as I once told my Med Lab Sci students, you should try to identify the 'so what' message of research papers. So too should blogs have a point. My biased musings on the results:
  • So much money is being poured into research for a vaccine and improved COVID-19 testing. It's a race to get there first among nations, including to have the vaccine manufactured in a country, as presumably that would give priority access to its citizens. 
  • Seems a rush to strike gold first. Potential for industrialized nation to get priority access and developing nations to be left out as often is the case. Think of recombinant FVIII being unavailable for ages in developing nations. Also countries like India where blood banks still use ELISA to test for HIV, Hepatitis B and C, rather than NAT.
  • Convalescent plasma is the flavour of the year of COVID-19. Results look promising but final results not in yet. More troubling is the notion that having antibodies allows you to return to work as you are protected. But scientists don't know yet whether people who've been exposed will be immune for life, as for measles, or if COVID-19 can return again and again, like the common cold. 
  • Big Pharma wants mega-money up front to fund COVID-19 research (Further Reading). Quote from article:
    • Particular concern over poorer countries’ access to medical supplies was highlighted by G20 health ministers’ failure at the weekend to issue a declaration of solidarity after this was blocked by the US
FOR FUN
I chose this Bob Dylan song as it reflects what's called the 'new normal' during COVID-19 and also reflects the current protests happening in the USA over the killing of a black man by a police officer. Somehow I suspect, with zero evidence, that the protests may be stronger and more widespread because of the coronavirus lockdown. Or perhaps because murder of black people by police has become all too common in America?

Chose Joan Baez to sing it for several reasons, the most important being she has a much better voice than Dylan. Also this version has the song's lyrics. Tidbit: Joan and Bob were once an item (Further Reading).
As always comments are most welcome.

FURTHER READING
TraQ's newsletters
Big Pharma calls for ‘billions’ in upfront coronavirus funding (20 Apr. 2020)

Joan Baez finally gets her public apology from Dylan (21 Sept. 2009)

Tuesday, March 31, 2020

We are the world (Musings on COVID-19's impact on the world's blood supply)

Stay tuned: Revisions are sure to occur
March's blog derives from the ongoing worldwide shortage of blood due to the coronavirus (COVID-19). Of course, because this is a transfusion medicine blog, I'm preaching to the converted. But I hope it gets wider distribution among all healthcare colleagues and the public beyond. 

Specifically, I ask all transfusion heath professionals to speak to colleagues, family, friends, neighbours about the ongoing need for blood donation, made even more crucial because of the COVID-19 pandemic. 

The blog's title is based on a 1985 song written by Michael Jackson and Lionel Richie for  'USA for Africa.' 

BLOOD SHORTAGES
For TraQ's newsletter, I've collated some of the ongoing blood shortages across the globe (Further Reading). Fact is, the need for blood transfusion is ongoing despite the COVID-19 pandemic. Yet blood donation has dropped off significantly in many nations for numerous reasons explained in the news items in Further Reading. 

TRANSFUSION NEEDS
Despite the ongoing efforts of the Transfusing Wisely initiative (Further Reading), implemented in many nations, regular need for transfusions still exits for many patients. Transfusing Wisely's general goals: Reduce the rate of unnecessary blood transfusions with the goals of lowering the risk of complications for patients and supporting the judicious use of valuable resources. 

For the general public, just some of the ongoing needs for blood transfusion include the following (not all inclusive):

Patients who need blood transfusions
  • Mothers who incur significant bleeding during delivery, including those with placenta previa
  • Gastrointestinal bleeding (if massive can be life threatening) with many causes such as hemorrhoids, peptic ulcers, tears or inflammation in the esophagus, diverticulosis and diverticulitis, ulcerative colitis and Crohn's disease, colonic polyps, or cancer in the colon, stomach or esophagus  
  • Kidney disease, sometimes secondary to type 1 diabetes, that requires dialysis
  • Any surgery that involves significant blood loss
  • Trauma patients including those in car accidents who experience blood loss and victims of knife attacks or gun shot wounds
  • Blood disorders, including
    • Thalassemia major patients need regular red blood cell transfusions to raise their hemoglobin level and deliver oxygen to body tissues
    • Sickle cell disease patients need regular red blood cell transfusions to provide normal red blood cells, lessen anemia and reduce the blood's viscosity, allowing it to flow more freely and ease disease symptoms and prevent complications
    • Leukemia patients who develop thrombocytopenia need platelet transfusions to control bleeding 
The need is real and ongoing. Please encourage colleagues, family, friends, and neighbours to donate blood and save a life. It's one thing folks can do during the pandemic. Further Reading includes questions about donating in Canada and blood systems in all nations have similar information. 

FOR FUN Naturally, I chose We Are The World, originally written for 'USA for Africa' in 1985 by Michael Jackson and Lionel Richie, produced by Quincy Jones and Michael Omartian, and sung by many fabulous American  artists.  
We are the world
We are the children
We are the ones who make a brighter day
So let's start giving...

As always, comments are most welcome and appreciated.
FURTHER READING
Australia: In the face of coronavirus pandemic, Australian Red Cross Lifeblood’s stocks are threatened (24 Mar. 2020)

Canada: Top doc says Canada still needs people to give blood amidst social distancing (17 Mar. 2020)
      Canadian Blood Services: Message by CEO Dr. Graham Sher
      CBS answers COVID-19 blood donation questions

Pakistan: Experts urge volunteers to donate blood as thalassaemia patients face shortage (22 Mar. 2020)

Spain: In COVID-19 emergency blood bank stocks in Costa Del Sol hospitals are alarmingly low (18 Mar. 2020)

UK: Blood donors needed after 15% drop, says NHS (23 Mar. 2020)

USA: Coronavirus fears threaten America's blood supply (12 Mar. 2020)

Transfusing Wisely Canada