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C'est si bon 

(Musings on TM news that is so good and not so good)

By Pat Letendre

May's blog is a take-off on cartoonist Gary Clement's weekly feature, 'Week in Review' in Canada's National Post, e.g, Week of Apr. 20-26, 2014. I love them because they capture the week's news with a smile.

The blog's title derives from an old ditty by Eartha Kitt, C'est si bon (It's so good).

The topics include an eclectic selection of news items in TraQ's newsletter in the first quarter of 2014. C'est si bon is an attempt to write shorter blogs. I'd love your feedback. Shorter is so good or not so good? Keep returning because I'll add the odd 'So...' periodically.

Usually, my BBTS blogs are original but, due to unforeseen circumstances, this blog also appears on my other TM blog site. I hope the content is relevant to transfusion professionals worldwide.

1. So creepy 

You take your dog to a vet and are told that the pet needs to be euthanized within 24 hours. Six months later you get a call from a former employee of the veterinary clinic who tells you that your pet was still alive and being bled for plasma to transfuse to other dogs. Say what?

2. So deservingThe CSTM promotes excellence in TM for Canadians. The 2014 CSTM award recipients are, indeed, deserving. I'm fortunate to know them all. 
3. So nerdy (added 11 May 2014)
Clever and simple, this is the type of chemistry trick we used to love in school. The kid in us still smiles, especially if we're nerds at heart.

4. So overdue
By the end of 2014, the USA's Physician Payment Sunshine Act will require drug companies to report every transfer of value (as little as $10) to doctors and academic hospitals on a public website. Canada needs to do the same.

Think it's overkill? Think again. See CMA President Dr. Louis Hugo Francescutti's take on doctors and drugs. Big Pharma's influence on docs has stunk for a long time.

5. So predictable
Dr. Sher's key points (my analysis):
So to all you 'worry warts' out there, don't sweat about whether paid plasma is safe. It definitely is. To Canada's elite evidence-based TM scientists, it's only about whether our values can embrace paying for plasma donations. Oh, by the way, without paid plasma patients will die.

As to the Ontario government's attempt to ban paid plasma, as predicted, the minority government has fallen and with it, all legislation.

6. So sad
The January 2014 issue of the AABB journal Transfusion reported that George Garratty, PhD, retired as associate editor of the Immunohematology section of Transfusion after 31 years of service promoting papers on red blood cell serology.

George was an icon to TM medical technologists. We will miss him dearly. 

The replies below are to comments made on my other TM blog site. Please add your comment to the BBTS site as it's interesting to learn how BBTS members view these issues.

In reply to Anonymous (11 May 2014)

Anonymous finds CBS CEO Dr. Graham Sher's public pronouncements on paid plasma in Canada both confusing and unreliable. Me too.
CEO Sher says that he doesn't want paid plasma clinics to open in Canada but, at the same time, he contends that paid plasma is needed to meet current demands for plasma derivatives in Canada and globally. Canada can only meet 30% of its needs. Moreover, he suggests that, without paid plasma, patients would die. 

Dr. Sher's key learning point: Like it or not, patients in Canada and the world need paid plasma.

The flaw in that argument is that Canada has never truly promoted plasma donation. Indeed, CBS closed a plasma collection facility because it was cheaper to buy plasma from the USA and (sadly and stupidly) obfuscated its reasons for the closure.

Dr. Sher also contends that today paid plasma is safe because of 'donor screening and testing, plasma quarantine, and technology that inactivates viruses, and several purification steps.' He's right, as far as it goes. 

But this reasoning assumes that no emerging infectious disease agents will appear that may escape the detection, inactivation, and purification steps involved in producing plasma derivatives. It also assumes that manufacturing errors will never occur.  And that, with today's system,  a disaster like hepatitis C contaminating Rh immune globulin can never again occur.

Perhaps CEO Sher suffers from cognitive dissonance, i.e., discomfort from holding conflicting beliefs. He contends that paid plasma is safe, and patients need paid plasma derivatives, but he doesn't want paid plasma clinics in Canada because CBS's voluntary donation system works well. Huh?

Cognitive dissonance aside, Dr. Sher is a clever man and has CBS spin doctors (communication specialists) advising him. He knows what he's doing. Any obfuscation is covered by emphasizing evidence-based decisions. 

Just like Canadian Red Cross medical experts did when rejecting surrogate tests for non-A, non-B hepatitis (now hepatitis C), which resulted in tens of thousands of Canadians being infected with HCV. 

Who can argue against evidence and science? Anyone who questions the safety of paid plasma is automatically and conveniently designated as non-scientific. 

In reply to Unknown (12 May 2014)

Unknown asked, 'Is there something in it for CBS and Dr Sher in supporting American paid plasma?'

Great question. What follows are possibilities. First, I believe CBS CEO Graham Sher to be an honorable man who mostly believes what he says or, paternalistically, believes he's doing the right thing for Canada by protecting our TM system from non-scientific types.

But it's not that simple. As AABB President it's possible he's drunk the Kool-Aid of American-style transfusion medicine, given the schmoozing he's no doubt done with Big Pharma and the laboratory diagnostic firms who support AABB, as well as with so-called not-for-profit transfusion labs that operate as businesses.

Or maybe he's into Real Politik, focussing on practical rather than ethical issues.

What's in it for CBS to support paid plasma? It prevents CBS from spending money to promote free plasma donation and to build and maintain plasma collection facilities. Both earn brownie points with CBS's provincial paymasters.

What's in it for Graham Sher to support paid plasma? It's about the money, stupid. Money CBS can save by NOT maintaining collection facilities and staff, as above.

In reply to Anonymous (13 May 2014)
Thanks to Anonymous, who supplied a link to yet another lobby group to promote paid plasma in Canada and noted that Canadian Plasma Resources has deep pockets: 
The press release is classic PR spin (emphasis is mine):
Made up of deeply concerned Ontarians, the Ontario Plasma Coalition was launched to address the provincial government's irresponsible handling of Ontario's plasma supply and its attempts at banning compensated donations with Bill 178. In partnership with Canadian Plasma Resources, the Coalition was formed following thousands of responses received through
Who knew that 1000s of deeply concerned Ontario citizens were practically marching in the streets to protest its irresponsible government's move to ban paid plasma?

Sheesh, you'd think the world would come to an end if Canadian Plasma Resources (CPR) didn't operate its paid plasma collection facility next to a homeless shelter and a centre for addiction and mental health. 

CPR built its facilities without Health Canada's approval, at least without its official approval. Who knows what went on behind close doors, including possible collusion by CBS (as in, 'Would you object?' Answer: 'No'). 

To me, CPR should shove its PR campaign where the sun don't shine. Just kidding!

To follow-up on the 'so' theme, enjoy these renditions of a popular jazz ditty from long, long ago:

As always, the views are mine alone and comments are most welcome.

Pat Letendre is the webmaster for the TraQ website of the BC Provincial Blood Coordinating Office in Vancouver, British Columbia, Canada.

Pat specializes in developing transfusion-related websites and managing mailing lists for health professionals. She has extensive experience as an educator and clinical instructor. 

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18 Feb 2020
10:19 am