Despite at least 8 on ice deaths in 9 years Hockey Canada’s Head of Safety, Todd Jackson told CBC that “We are at a point where we are delivering something we are very comfortable with” when asked if his organization was doing enough to prepare for and respond to cardiac arrest.
In Ontario, OPHEA, the organization charged with setting guidelines for safe and healthy schools has given Arrhythmia Diseases a place of prominence in their Sample Information Letter to Parents/Guardians and Medical Information Formand provides a brief overview of Heart Arrhythmia Diseasesas Appendix “M” in their guidelines. Unfortunately Boards, Principals and Teachers are not mandated to follow these guidelines.In my significant personal experience I have found Educators in Ontario to be largely unaware of all aspects of arrhythmia disease including common warning signs.
Legislatively no Canadian province has passed a bill targeted at preventing Sudden Cardiac Arrest in Youth, the #1 killer of young people at schools and at community sports venues. (At the time of writing a Private Members Bill is being drafted in Ontario. Thank you Christine Elliot and Dr. Kirsh) In the United States there are at least six states with legislation passed and six or more with legislation pending.
In this century alone at least 10,500 young Canadians have died suddenly of cardiac causes. For the entirety of this century organizations such as The Canadian SADS Foundation (Sudden Arrhythmia Death Syndromes) have been promoting the warning signs of Heart Arrhythmia. Paediatric Electrophysiologists (physicians that specialize in treating electrical diseases of the heart) have provided the scientific rationale for the warning signs and endorsed the widespread dissemination of them. Sadly awareness and prevention initiatives have gained zero traction in this country. If the road to an effective national prevention strategy for sudden cardiac arrest in youth is 100 miles long Canadians have taken no more than one or two steps since the 1990’s. The investments (mostly non-monetary) required to reduce the 700 young person deaths each year have simply not been made, rarely even discussed.
In contrast, I sat at my desk, on a cold and drizzly October afternoon in 2009, and watched parents drag their children a kilometer or more down a busy roadway to line up outside in the rain for up to two hours to receive a vaccine for a strain of flu (H1N1) that despite its advanced billing ended up being relatively benign. Health Canada estimates of the potential for between 2,000 and 8,000 flu related deaths in Canada that year vastly overestimated the reality of the 428 H1N1 deaths, mostly older adults with co-morbidities, reported in Health Canada’s final report on the pandemic. The point I want to make is that with little to no evidence to back their play healthcare officials used their legal and moral authority to mobilize resources, spend significant public monies often by accessing emergency funds, require healthcare workers to put in overtime, mandate lower levels of government to respond immediately to demands for human resources and facility space. In all it was an impressive, expensive, coordinated, lightning quick response, that while probably unnecessary, demonstrated what the various levels of Government in Canada are capable of when they set their collective minds to a task. The 62 page final report from Ontario’s Chief Medical Officer of Health is at least 60 more pages than any government official working in healthcare has ever written on prevention strategies for the heart arrhythmia diseases that claim the lives of 700 otherwise healthy young people each and every year.
On October 27, 2014 I will be attending the first ever National Strategy for the Prevention of Sudden Death in the Young meeting at the Canadian Cardiovascular Congress in Vancouver. (Thank you Dr. Sanitani and Dr. Krahn) A small group of EP’s and other stakeholders will hopefully begin to delineate some critical pathways and kick start some meaningful prevention activities across the country. This meeting coupled with the proposed Private Members Bill in Ontario is as much positive activity as we have ever seen. In my next blog I will report on the discussions at the Vancouver meeting as well as work we are doing with Ontario School Boards and Hamilton area Family Health teams. By October 2015 perhaps we can be a mile or more into the 100 mile journey.