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MUST READ LONG TWEET on #TurkeyTylenol Please repost if you agree. Let’s put this into human terms, the impact on Alberta’s children in fall and winter 2022. A new Premier rejected key public health advice on vaccination and viral spread, and removed the Chief Medical Officer of Health (Dr. Deena Hinshaw) on Nov 14, 2022, during a “tridemic,” when multiple respiratory viruses were circulating at the same time. Many Alberta children became ill. Most had typical viral infections. But many became very sick. Not minor illness, but serious complications. They were dehydrated. They were struggling to breathe. Some were septic. They filled hospital and ER beds across Alberta. During this period, a ~$70 million children’s acetaminophen procurement was announced as part of the response to this crisis by Premier @ABDanielleSmith This human story has been lost, while key facts have emerged through reporting by: 1. City news: @jsjamato edmonton.citynews.ca/video/2… 2. Cindy Tran: Postmedia @kccindytran edmontonjournal.com/news/loc… 3. Globe & Mail team: @CarrieTait, @Tom_Cardoso & @alanna_smithh theglobeandmail.com/canada/a… There is now an Auditor General investigation, a judicial review and addendum, and RCMP involvement. How did we get here? Policy decisions were made in a fast-moving crisis. The question is, were they evidence-based and well governed? …the answer is…NO. As an ER physician, former Associate Health Minister, HQCA Board Chair: Acetaminophen (Tylenol) is not life-saving. It treats fever and pain, not the illness. 1. FACTS: • Fever rarely harms; the underlying infection does • Treating fever improves comfort, not outcomes • Frontline clinicians were not calling for $70m and large stockpiles of children’s acetaminophen or anti-inflammatories 2. MORE FACTS: • There was a real shortage across Canada, driven by demand • The U.S. faced similar pressure without declaring a national shortage • Health Canada ensures safety and access • Provinces decide what to buy, how much, and from whom Emergency importation was allowed, not full approval. • Alberta committed ~$70M for ~5 million bottles • ~1.47 million bottles (~$20M) were received Public reporting indicates: • ~1% of product was used • Large quantities expired and were destroyed • Some product was donated • Significant funds were paid for product not delivered This raises serious questions about value, decision making, planning, and oversight. 3. WHAT WENT WRONG: • Large-volume procurement under uncertainty • Limited transparency • Delivery gaps • Overstock → expiry and disposal • Storage (~$478K) and disposal (~$718K) costs • Ongoing investigations, including reported RCMP activity This does not appear to be a clinical failure. It raises concerns about procurement and political governance failure. 4. THE QUESTIONS THAT MATTER: • Why ~$70M on a non-life-saving medication? • Why elevate it to a Premier-level response? • What procurement process was used? • Were established suppliers (Apotex, J&J) considered? • Who approved volume, pricing, and payment terms? • What due diligence was done on supply and shelf life? • Were risks (expiry, non-delivery) assessed? • Where does accountability sit: AHS, Alberta Health, the Minister/Premier’s office, or all three? 5. MOST IMPORTANTLY, WHAT WAS HAPPENING TO ALBERTA’S CHILDREN: ERs were not full of kids needing acetaminophen, Tylenol & anti-inflammatories. They were full of children and adults with serious complications from infections requiring: • Oxygen • Monitoring • IV fluids • IV antibiotics • Hospital and ICU care Pediatric hospital beds were full. Admitted patients, including children, stayed in ERs for prolonged periods. Waiting rooms backed up. This was a capacity and flow crisis that exists today. 6. THE REAL PROBLEM: The “Tridemic,” multiple infections at once: • RSV • Influenza • COVID-19 7. WHY IT WORSENED: • Less consistent public health messaging (no Chief Medical Officer of Health) • Suboptimal vaccination uptake (new gov't policy) • Variable masking and mitigation (new gov't policy) • Limited clear guidance (new gov't policy) • A predictable winter surge 8. THE REAL EMERGENCY, STILL PRESENT TODAY: • Insufficient hospital capacity • Workforce shortages • Limited primary care access • Gaps in home and long-term care • Ongoing system flow challenges 9. WHAT SHOULD HAVE BEEN PRIORITIZED: • Medical leadership to inform elected officials • Measures to reduce transmission • Vaccination and public education • Procurement aligned with clinical need • Multiple reliable supply sources • Strong primary and community care • Planning ahead, not reactive purchasing 10. BOTTOM LINE: This was not about fever. It was about serious infections overwhelming an understaffed, under-built, and strained health system. You don’t fix that with Tylenol. You fix the underlying cause and repair the system. A wise old man once told me that to fix healthcare, we need 3 things: 1. Money - accountable investment 2. Manpower - trained staff 3. Materials - beds, infrastructure, and medical equipment 11. SOLUTIONS: • Strengthen governance and oversight by separating policy-making from front-line operational decisions • Improve transparency and accountability • Align political messaging with clinical reality • Invest in human and capital infrastructure where patients need care Public reporting and ongoing investigations have raised serious questions about decision-making. Those processes are ongoing. 12. MEANWHILE: Albertans continue to experience delays in care, including cases of deterioration and deaths in ER waiting rooms while waiting, as highlighted by Dr. @pfparks and Alberta’s emergency physicians. 13. My question: If one high-profile procurement shows these gaps, what does that mean for the rest of healthcare and government spending and contracting? Albertans deserve answers. Albertans deserve transparency. Albertans deserve better leadership. 14. FINAL THOUGHT & QUESTION: Have we as a society and our government learned anything? #ABleg #ABpoli #AHS #ABHealth @Alberta_UCP @RachelNotley @albertaNDP @djclimenhaga @cspotweet @ryanjespersen @TheBreakdownAB @ShayeGanam