This month’s blog is an excerpt of an Op-Ed co-authored with two friends, Dr. N. Dosani, an inner city palliative care physician, and Dr. N. Kaplan-Myrth, a family doctor in Ottawa. We continue to think about the vaccine dilemma and how to enhance our strategy, recognizing that each of us, our families and communities have a vested interest in finding the most efficient and equitable way to rollout and administer the Covid-19 vaccines to Canadians.
Sometimes, like the little one in the graphic for our blog, when we are faced with a big set of stairs to climb, a big challenge to overcome, a big problem to solve, we freeze. The challenge of vaccinating millions of adults is literally a great big wicked problem; one that is too big for government, or public health alone to develop solutions for. A wicked problem is defined as one that is difficult, unclear and tests our values and use of evidence. A wicked problem has no singular, simple solution. Vaccination planning is a wicked problem that needs a whole community approach where everybody has a role to play.
The secret to dealing with a wicked problem is to think outside of the box. This requires letting go of professional and jurisdictional barriers; moving beyond healthcare’s traditional “silos.” People and communities are affected differently by the pandemic and will be able to bring different ideas and strategies about how to best reach their communities with vaccines. To do that, we have to find ways to trust each other, to make the walls between us more permeable. A wicked problem will not be solved by one sector and requires the input and efforts of entire communities. People do not exist in, nor do they think they belong to, a single sector, a specific hospital, a particular demographic or a single healthcare discipline.
We need to bring vaccinations to Canadians, where they are, in their communities. Each community has its unique population, challenges and strengths. By engaging with health care providers and those who live in the community in the planning, we can ensure that vaccination strategies are developed and delivered within a health equity framework. Vaccination plans have to be attuned to the needs and barriers encountered by seniors, people with disabilities, Indigenous people, those housebound with illnesses, people of colour, people who live in poverty, migrant workers, and other marginalized populations across a variety of settings in Canada: a great big wicked problem that no one solution will address!
Transparency and clarity are what will mobilize communities to combine their efforts to move us past the pandemic. A part of the solution to this wicked problem resides in finding our way back to our North Star – the patient, caregiver, person at the centre of what we are doing. To do otherwise brings poverty to the vaccine effort.
Together, we can get this job done. We have an opportunity to equitably accelerate the distribution of vaccines if we recognize the role of community. Our national and provincial/territorial vaccine strategies need leadership willing to review the strategy and plans with humility, always seeking to improve the solutions. There is no single right answer to the dilemma. What does remain constant is the fact that how we decide to deliver vaccinations reflects our values and what we regard as important. We can leave no Canadian behind.
For months we have talked about being in this together, of getting through Covid-19 together. Now is when we have to make #InThisTogether more than a hashtag.