We are all wondering what the full impact of the pandemic will be. How much longer will we have to stay apart? What strategies and tools will continue to be created or leveraged to help us navigate the challenges? What are we learning as we anticipate the next time? And how will we ensure that what is moral and just is foundational to how we strategize as we plan for the worst and hope for the best.
Within our organizations, programs, services and systems Accreditation that examines how we are doing and where we need to go can help us get there.
‘Epidemic diseases are not random events that afflict societies capriciously and without warning. () Every society produces its own specific vulnerabilities. To study them is to understand a society’s structure, its standard of living and its political priorities. Throughout history, epidemics turned pandemics have recurred, resulting inevitably in significant losses of life.’1
So, what does that reveal about our social structures, standard of living, health and political priorities?
Consider the 1918/19 Influenza pandemic, when 3% of the world’s population died, and the 1956/58 H2N2 that resulted in 2 million deaths. Both inequitably affected people who were vulnerable across many domains, including race, income, gender and access to healthcare. Similarly, many of us currently recognize the impact of HIV, Ebola and Cholera as diseases that have not disappeared but continue to challenge science and research because they resist eradication and simultaneously remain a threat to marginalized communities around the world. So, we must ask who is most at risk during this highly contagious pandemic? And what can we learn, take responsibility for and then act to redress?
Health justice and equity form the bedrock of community‐based health and social systems everywhere, and these are articulated in the principles and elements of the social determinants of health2. The inequitable distribution of resources that ignores and increases risk for specific populations contributes to the inevitable perpetuation of endemic diseases that can become pandemic, putting everyone in jeopardy.
During the current coronavirus pandemic, we have an opportunity to rethink, rewrite and retest emergency and pandemic plans. We can discuss what we are learning and commit to ongoing improvement, as we face new threats to our communities, populations and existing health and social systems. It is only when we choose to search those places, intentionally hidden from view, that we can determine who is most at risk. This includes people who live rough, are poor, are housed in densely populated neighbourhoods, and where people are hidden away from public scrutiny: in prisons, mental health institutions, Indigenous communities, seniors’ residences and institutions. Only then can we create effective health and public health strategies as we anticipate the inevitable next outbreak. As one doctor from a Vancouver hospital said, ‘I have never read our Pandemic Plan and yet I know by heart the Codes of Orange, Blue and Red. But they did not help me this time.’3
And that is why an Accreditation model that is designed within an equity framework can contribute to creating a more just, inclusive health and service system. And, it is through recognizing the need for ongoing quality improvement in clinical, health, mental health and social services across populations, that antiracist, anti‐oppression and principles of inclusion enshrined in policy and implemented in practise will actually matter, when we face the next pandemic.
‘The health of the most vulnerable people among us is a determining factor for the health of all of us, and, if we aren’t prepared to do that, we’ll never, ever be prepared to confront these devastating challenges to our humanity.’4
During this time, CCA is continuing to work on infrastructure and service‐related improvements to ensure better service to our communities by:
- implementing more robust technology and Web capacity;
- continuing to update Standards and tools according to scheduled ongoing improvement ;
- outreaching to current participating organizations to check on your capacity to proceed with your accreditation;
- discussing deferrals for imminent planned reviews; and
- supporting our partners and colleagues
We are also and most excitedly in the final phase of developing a virtual site visit module and will be launching a virtual module for Training Reviewers this month.
And finally, we want to thank all front line and support workers and those you love and care about across our participating organizations and broader communities for your commitment, resilience and kindness during this challenging time. To everyone who is struggling and vulnerable, we wish you the physical and emotional strength to be well, be safe and take care of yourselves as you take care of others.
With Compassion and Caring,
The Staff and Board of CCA
1 Frank Snowden, Professor of Medicine, Yale University. ‘Epidemics and Society; From the Black Death to the Present’ 2019.
2 A Conceptual Famework of the Social Determinants of Health defined by WHO 2010‐ e.g. safe housing, livable income, education, food access, gender and racial equity.
3 White Coat Black Art 2020 May 30th, 2020, with Dr. Brian Goldman, ER physician, Mt. Sinai Hospital, Toronto.
4 Frank Snowden, Professor of Medicine, Yale University and author of ‘Epidemics and Society; From the Black Death to the Present’ 2019.