In June 2020, Calgary-based Orpyx Medical Technologies, a medical device manufacturer of sensory insoles to help prevent diabetic foot ulcers, and a portfolio company of Western Economic Diversification, announces an interesting partnership.
/4
Capacity for "8 million ASTM-certified, 3-ply procedural face masks a month with room for expansion" is a huge investment to make without a confirmed major customer.
Guess from the announcement who that major customer is
The urgency around GoA's current pursuit of 5m bottles of children's pain & fever no matter what the business case reminds me of Orpyx contract that was portrayed as "Bits & Pieces" help, but from its early days, was a massive untendered (?) subsidy.
/6
Unclear to me why in Summer/Fall of 2020, if GoA wanted to establish domestic manufacturing of PPE, why it invested $60m to be an also-ran in commodity manufacturing of procedural masks.
The need was, and remains, for Made-in-Canada respirators.
/7
So let's turn our September 2020 eyes from Procedural Masks
where AHS dropped $60m into a glut of national capacity
to N95 equivalent Respirators
where incumbent 3M could not meet soaring demand from 2nd/3rd/4th Wave.
Bizarre AHS decisions again.
/8
In the above 24 Sep 2020 video, AHS Executive Director of Workplace Health and Safety advises that both 3M N95 at the core of AHS fit-tested respiratory protection were no longer available:
• Aura 3-fold boat design
• VFlex easy-breathing duckbill
/9
Exec Dir of WHS explains they are filling in temporarily with 3M 8210/8110s cup-style industrial N95..
but instead of diversifying to a Canadian-made replacement, they somehow made Shanghai Dasheng DTC3Z their number one choice, and would be actively fit-testing to that.
/10
So, AHS feels locally-made flat masks are so important they spend $60m to get $24m of commodity product made in Calgary.
But for even more important respirators, instead of going to Canadian manufacturers innovating with Health Canada, AHS goes to China for 3M Aura clones.
/11
Yes, dear readers, you'll be GOBSMACKED to learn that within a year of AHS commitment to Shanghai Dasheng as #1 respirator for fit testing..
..both US FDA & Health Canada revoked their interim approval of every single Shanghai Dasheng respirator.
/12
By Oct 2021, it should be clear to AHS:
• Dasheng abandoned Canada/US N95 market
• Delta/4th Wave filling up ICUs and burning out HCW
• 3M cup-style N95 with no exit valve (temporary fallback until Dasheng) are hurting HCW over long shifts, eg.
/15
So a rational, ethical employer of AHS's size & complexity would realize it urgently needs millions of respirators that are:
• Health Canada approved
• meets Alberta OH&S Code
• comfortable for extended use by HCW
• NOT another Vanch fiasco
/16
Rational, ethical things AHS could have done in Fall 2021:
• Go back to 3M Aura & VFlex ramped up manufacturing to meet HCW demand (they had)
• See the progress of Canada's industry/government collaboration, especially @CAPPEM2 & @GovCanHealth
/17
@CAPPEM2@GovCanHealth In Aug 2020, govs of Canada & Ontario each kicked in $23.33m to expand 3M's N95 production in Brockville, ON to 100m/year, with each gov committed to 25m/yr for 5 years.
In Fall 2020, Ontario and the feds invested $46.67m for 50m world-class N95/yr from 3M.
Just under a dollar each.
Leaving 50m/yr of capacity.
Did GoA go for it? Not Trudeau, but Kenney & Ford are friends, right?
Nope. GoA dropped $60m on Orpyx flat masks at $1.50 each.
/19
When I say GoA got $24m of masks for $60m, I am comparing to AHS landed cost for Primed PG4-196612 procedural masks in Summer 2020, when PPE was at a premium, and AHS was desperate, buying volume well above contract price.
In summer 2020, it became obvious that Canada would be nearly self-sufficient in PPE manufacturing, especially in manufacturing 3-ply polypropylene flat masks, which is fairly straightforward for the disciplined manufacturers we have across Canada.
/21
I defer to @BarryHunt008@CAPPEM2 if they wish to comment, but I understand a contract for 40m Canadian-made ASTM F2100 L1 flat masks over 2 years starting Fall 2020 would be a small fraction of $1.50 each.
Let's check our roadmap. I've covered procedural mask and N95.
Not yet KN95 😱
By Fall 2021, GoA & AHS *should have* learned from Vanch, Orpyx & Shanghai Dasheng fiascos.
The urgent need was for fit-tested respirators to replace the 3M 8210 & 8110s cup-style N95.
/23
Don't get me wrong. 3M 8210 & 8110s cup-style N95 (which AHS intended as a temporary stopgap to get them to their preferred supplier Shanghai Dasheng) are not BAD respirators.
I agree with most of what @larmbrust says in his review.
"In Canada, women represent 82% of HCWs, but most masks and respirators have been designed based on the anthropometrics of average men in the US & Europe."
Past bedtime for me, but I will pick up on this later,
/26
As @larmbrust shows in his video, the 3M 8210 cup edge presses tightly against the face, even through stubble. Reliable seal, but tough on skin.
It's also a stiff mask that clamps the mouth a bit, and dampens the voice, affecting HCW who speak more than industrial workers.
/27
@larmbrust The 3M 8210 and 8110s (for small) were approved by NIOSH in 1995.
They became entrenched in industrial workplaces which require regular fit-testing, because the pressure of the cup edge on skin helps ensure a seal on many faces.
Informative conversation between @masknerd and 3M's Nikki McCullough.
Millions of users around the world have been fit-tested to a specific 3M cup-style N95. So 3M improves things like comfort as far as they can without changing that form factor.
/29
@larmbrust 3M's marketing literature claims the "Healthcare" versions of their N95 have around the same breathability of ASTM F2100 flat masks. 5 mm H2O is about 50 Pa.
I have worn both the Orpyx L3 flat masks and the 3M 1804 VFlex N95, and prefer the N95.
/31
I volunteer with many HCW and other professionals who do not have this reference information.
If you work for AHS, your health & safety depend on getting information directly from 3M and other reputable manufacturers.
/32
Did you notice 3M compared breathing resistance:
• only for their Healthcare N95 (40 to 60 Pa)
• against the (Halyard) competition (100 - 120 Pa)
• but not their Unvalved N95 (100 - 125 Pa)
• eg the 8210 which AHS decided on for HCW (100 Pa)
/33
Why?
• Many workers prefer N95 with an unfiltered exhalation valve, to keep the inside of their respirators cool, and their breathing easier
• HCW cannot have that
• So 3M makes these specialized versions of popular N95 forms, with lower breathing resistance, for HCW.
/34
Serious problem from AHS deciding on 8210/8110s as fit-tested N95 for HCW.
• They're not fluid resistant 💥😱
• Procedural masks are fluid-resistant
• AHS defines COVID-19 as contact/droplet hazard
• HCW required to add eye protection, not face shield
@kim_siever Thanks, Kim. I collected boxes & QC certificates - between us we have 4 different manufacturers.
I believe Vānch is just the PPE brand of stationery supplier Beifa Group, who bought whatever mani-pedi flat masks they could find, and repackaged them.
/45
@kim_siever On 20 Oct 2022, Supply Chain Advancement Network in Health held Dialogue Forum I in Edmonton, hosted & sponsored by Alberta Innovates, co-sponsored by Shoppers Drug Mart & GS1 Canada.
Chief Program Officer for AHS CPSM gave an interesting Keynote.
/46
20 April 2020 #COVID19AB Theatre at which Prasad presented. Total 55 min, most taken by other topics like NS mass shooting, oil & gas, Cargill outbreak, and CMOH update.
The few "1 question/1 followup" he got was no grilling.
/48
I'm one of the critics who knew better:
• Chinese YY/T 0969 standard is NOT fluid resistant and does not look below 3 µm filtration
• All ASTM levels filter at 0.1µm >95%, and are fluid resistant at least 80 mmHg
• I asked to see the test results
/49
Around 27 April 2020, AHS put out this deceptive spin:
• impossible claims about the masks tested and meeting mutually exclusive standards
• but not releasing those test results
• setting up channels for staff to complain internally, not to media
/50
@laurby@John1MD@Arfarfarf8@FionaMattatall AFAIK, here are 17 Mar 2020 test results AHS kept from you.
• true manufacturer Anhui calls them YMJ1
• they meet EN14683 Type II (not ASTM, not fluid resistant)
• YMJ2 is kids mask; YMJ3 meets Type IIR (fluid resistant) but is different mask
/52
When repeatedly challenged for what standard the PPE meets, and for proof it meets that, the ethical employer provides manufacturer documentation, and the March 2020 independent lab test results it claims to already have.
So let's recap again. In this thread, tweets:
• 1-7 Orpyx procedural masks
• 8-40 fit-tested respirators - URGENT concern over fluid resistance
• 42-56 history of deception by @AHS_media with Vanch, which destroyed their credibility to handle subsequent problems with BYD
/57
@AHS_media Thank you @TheBreakdownAB for having me on the show Sunday to "Show & Tell". I started ~41 min mark and ended 45 mins later.
I am blowing the whistle on AHS CPSM and WHS, and discovering more problems as I double-check.
Many serious questions.
/58
@AHS_media@TheBreakdownAB On Tue 6 Dec 2022, my parents tested positive for COVID-19 at their Carewest LTC, by rapid tests I conducted (later PCR-confirmed).
While I have always been concerned about AHS IPC, this made those policies and the PPE on the AHS isolation cart my business to know.
/59
Why did I rapid-test my parents? Because Carewest policy before they will authorize antiviral therapy - confirmed by physician & RN in charge - is to wait for PCR results.
Which is 2 days, or Wed at earliest for Mum. Dad was not swabbed until he was symptomatic Tuesday.
/60
I looked up the AHS policy for Paxlovid & Remdesivir after my parents' doc called me Monday. Although he had told me we had to wait until the PCR result, AHS policy since Sep 2022 accepted a positive Rapid Antigen Test too. Every day is crucial.
/61
Questionable decisions by AHS on Masks & Respirators.
In December 2021, AHS deployed massive amounts of BYD earloop KN95 for staff & visitors.
Staff HATED them. The earloops were too tight and said "like breathing through a maxipad."
/64
Not until February before AHS Exec Dir of Workplace Health & Safety addressed them in "PPE Question of the Week."
• staff in congregate living facilities, not acute care
• can provide higher protection than procedure mask
• 2 metre or AGMP for N95
/65
According to the WH&S executive's video, staff in congregate or continuing care aren't supposed to wear a KN95 around COVID-19 patients?
That is NOT what the procedures say. Let's start here
So on 3 Feb 2022, AHS Exec Dir of Workplace Health & Safety makes a video saying staff should not wear the KN95 instead of a fit-tested N95.
But the procedures on 14 & 17 Feb for staff in congregate or continuing care say they can wear N95 or KN95 or procedural mask
/68
You may say "Ziad, be forgiving. Paperwork mistakes under pressure."
I respond:
• Why is AHS distributing KN95 to ANYONE in December 2021?! And still doing so TO THIS DAY?
• Aren't the lives of nurses & patients in congregate care just as valuable as those in acute care?!
/69
You can see this double-talk & double-standard in the PPE principles for facility screeners.
AHS claims N95 or KN95 or medical mask are all considered safe practice for continuous masking, but KN95 masks are not used at acute care sites.
"Note: Provincial OHS legislation does not include non-fit tested respirators (eg KN95) in the legislative definition of a respirator. Therefore, in Alberta, KN95s are called masks rather than respirators."
"Do not use an N95 respirator if fit testing is not current...If fit testing is NOT available or current then don a seal-checked KN95 mask or well-fitting procedure/surgical mask."
Staff can't wear seal-checked N95. I've asked.
KN95.
Anyone seal-checked a procedure mask?
/72
Now, the most serious issues with BYD KN95.
Effective 6 July 2021, US FDA revoked Emergency Use Authorization for both BYD KN95:
• DG3101 earloop
• DN1102 headband
US Hospitals use N95s for COVID-19; they don't pretend procedural masks are OK.
/73
Without approval under an Interim Order from Health Canada:
• either as a medical-grade mask under ASTM F2100 or EN 14683
• or as a respirator under CSA Z94 or interim🇨🇦 guidance
The BYD KN95 could not be medical ANYTHING.
Only "face masks" like a common dust mask.
/75
After FDA revocation, neither BYD, nor any importer or distributor representing them, obtained Health Canada approval as a medical device.
So why is AHS distributing them to visitors at all sites, and to staff at congregate care as N95-equivalent PPE?!
So who would have picked up BYD Canada's liquidation of defective children's masks & unauthorized KN95 "respirators" at the end of 2021, and resold them to GoA?
Maybe MHCare Medical, the same people behind the Vanch masks. That AHS falsely claimed were ASTM Level 1.
/79
Even if we ignore that AHS is providing staff BYD KN95 as PPE without Health Canada or FDA approval, they are still unbearable masks.
NIOSH tested them in April 2020.
• 223 Pa breathing resistance
• nearly 4x the maximum for a procedural mask
So I have to ask AHS:
• what was the point of ordering KN95 when the need is N95?
• how is a non-fit-tested KN95 better than a non-fit-tested N95?
• let's see your due diligence
IMHO, it looks more like enriching the supplier at the expense of staff and visitor safety.
/83
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More evidence AB Health Min LaGrange never intended ANY vaccination in physician's offices continue past April 2024.
Feb 2024: she "specifically asked" Alberta Pharmacists Association if they could do it, even if beyond their current scope of practice.
@drDavidKeegan @JMeddings
@drDavidKeegan @JMeddings @JenLeeCBC @TheBreakdownAB @TehseenLadha @Albertadoctors For the evidence she lobbied them, rather than the other way around, search Alberta Lobbyist Registry for "Alberta Pharmacists" to see their 9 Oct 2024 semi-annual filing.
For background, see @JenLeeCBC excellent reporting, especially this tweet and my 4 replies to it, showing how Min LaGrange gamed Alberta Purchasing Connection to only put out an unprecedented RFEI for this, not an RFP as she falsely claimed.
ICYMI, my request Friday to Minister @AdrianaLaGrange to recoup $49.4m from MHCare Medical/Atabay boondoggle.
Sorry to openly copy AB reporters, but questions at her pressers are so restricted.
@alanna_smithh @Jantafrench @ByMatthewBlack @gthomsonink @MBellefontaine @JenLeeCBC
@AdrianaLaGrange @alanna_smithh @Jantafrench @ByMatthewBlack @gthomsonink @MBellefontaine @JenLeeCBC I wasn't aware that on 10 Aug 2020, then-Education Minister Lagrange had fired a pre-emptive deceptive strike at Alberta's Ethics Commissioner Trussler about the IFR chlorine masks purchased within the previous two (2) weeks from a company in her riding.
@AdrianaLaGrange @alanna_smithh @Jantafrench @ByMatthewBlack @gthomsonink @MBellefontaine @JenLeeCBC Complaint alleged the Minister lied by claiming her political staff were NOT involved.
There are, as expected, MANY reports like this of Vanch mask problems.
Some mistakenly filed as PRIMED, but all correctly identifying importer MHCare Medical and/or the Beifa Group Chinese exporter printed on the box.
@John1MD @RajBhardwajMD
A large number of POWDER FREE NITRILE EXAMINATION GLOVES that MHCARE MEDICAL CORPORATION DBA MRAICHE HOLDING CORPORATION imported from
SHIJIAZHUANG HONGRAY GROUP CO.,LTD.
with typical MHCare Medical problems:
• poor material or build quality
• skin inflammation, rash, etc...
1. Danielle Smith ordered EVERY shipment of the $80m MHCare Medical/Atabay children's acetaminophen boondoggle to be AIRLIFTED at taxpayer expense.
2. It's likely these airlifts were handled by MHCare Medical too, with their usual profiteering off the Gov of Alberta.
🧵
How do I know Item 1 above? Well, for starters, Smith told us in her opening PR stunt.
Stupid, wasteful decision. Even if you truly believed you were solving a shortage, you might airlift the first 1-2 shipments, while bringing the rest by ocean freight.