April

As this editorial is being crafted, Russia has invaded Ukraine and we are into year 2 of a global pandemic. People are discouraged and tired. Public patience is being tried, as demonstrated by recent freedom convoys and the occupation of Ottawa (as an aside, it wouldn’t be possible to have such demonstrations in a country that wasn’t free).

Thank you for your letter. We agree with the small-steps approach and have been working to lessen our environmental impact for many years. The small steps that we have taken include:

It is becoming increasingly clear that our future health, as well as the health of future generations, is linked to global planetary health, including the preservation of the natural environment, appropriate use of resources, and engagement of sustainable systems.[1] The Board of the Vancouver Medical, Dental, and Allied Staff Association/Vancouver Physician Staff Association is very supportive of Vancouver Coastal Health’s formal adoption of planetary health as a strategic priority via the creation of an official planetary health portfolio, with Dr Andrea MacNeill leading

I appreciate Dr Kotaska’s comments on the amniotic fluid infection/inflammation (AFII) autopsy quality assurance study recently published in the journal [BCMJ 2021;63:383-387]. The practice at BC Children’s and BC Women’s Hospitals is to sample for bacteria from areas that are unlikely to be artifactually contaminated at or after delivery, such as the lung and stomach contents.

I thank Dr Terry for his informative article [BCMJ 2021;63:383-387]. Of the many causes of preterm birth, finding an infectious agent gives hope that treatment might prevent recurrence. However, most bacteria identified during autopsies are commonly found in the lower female genital tract. Their culture from fetal surfaces, lung, and stomach may represent colonization during transit through the maternal vagina rather than pathogenicity.