In his luncheon address at the National Press Club in Washington, DC, this Tuesday, Tom Frieden, MD, Director of the Centers for Disease Control and Prevention, put this question to the audience:
“What do these 6 organisms have in common besides the fact that they’re all infectious diseases? MERS [a viral-caused respiratory illness that kills about 1/3 of the people who get it], Ebola [viral-caused internal bleeding], measles, multi-drug resistant TB, C. difficile [gut bacteria that causes severe diarrhea], and CRE [the new ‘nightmare bacteria’ that kills half the people who get it].”
The audience was stumped so he offered a clue: “It has to do with how they spread,” he said. Still, no one got it.
The answer is: “They’re all – very importantly – spread in hospitals. We [hospital personnel] can be part of the problem if we’re not careful,” he said.
Tom Frieden was being candid about a subject we’ve addressed many times before, namely, that the hospital is an inherently dangerous place. For example, we’ve reported that: there is sometimes a surprisingly high rate of infection carried by hospital staff; Hospital-Acquired Infections cause more deaths in Canada each year than breast cancer, HIV/AIDS, traffic accidents, and homicides combined; lab coats, stethoscopes, smartphones and tablet computers used by doctors and nurses are magnets for bad bugs; on the high rate of physician non-compliance with hand hygiene protocols; hospitals are built in such that they aid and abet the spread infections, and, finally; the ease with which hospital cleaning procedures can actually spread pathogens instead of getting rid of them, summed up in this superb and highly infectious video, THE BUG ZONE, made by, and featuring, some creative hospital staff in Winnipeg, Canada.
When legendary bank robber Willie Sutton was captured by FBI agents in 1934 they asked him why he robbed banks. He said, dryly, “Because that’s where the money is.”
“I do think that people need to understand that the hospital is an inherently dangerous place and it’s not because hospitals are dirty or doctors are lazy or anything like that. Think about it this way. You’re taking the sickest people in society, crowding them into one building, tearing new holes in their bodies that they didn’t use to have by placing plastic catheters in their bloodstream, their bladder, putting tubes into their lungs that can breathe for them, and we’re using very large quantities of antibiotics to treat infections. So that’s a perfect breeding ground to generate antibiotic resistant bacteria.”
There’s a saying among hospital physicians: “The longer you stay the longer you stay.” That is, because hospitals are so full of germs – susceptible and resistant – the longer you stay the greater the risk that they will get hold of you and make you sick, or worse.
So as it turns out, the trick to a successful hospital stay is much the same as the trick to a successful bank robbery – get in and get out as quick as you can.