A few days ago we reported on how the hospital – of all places – is a dangerous place for the sick because it is an ideal breeding ground for germs. The words of infectious disease expert Dr. Brad Spellberg are worth repeating:
“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.”
The focus of his words are on the patients themselves and how they are a threat of infectious disease. There is, however, another aspect of the hospital environment that constitutes a serious disease threat that we didn’t talk about, and that is the extent to which hospital staff themselves are infected with antibiotic resistant illnesses.
A few years ago the Winnipeg Free Press told us that 18 outbreaks of serious illnesses were reported in local hospitals between 2006 and 2008. The really interesting bit is that documents obtained through the Freedom of Information Act (the hospitals did not volunteer this information) showed 803 patients and 609 hospital staff were infected (they were not just carriers) with illnesses such as Norovirus, methicillin-resistant staphylococcus aureus (MRSA), C. difficile, and vancomycin-resistant enterococci (VRE).
Dr. John Embil, director of infection control for the Winnipeg region, told the Free Press that health officials anticipate outbreaks every year, that the microbes are spread by health-care workers because they can linger on anything including walls, bed rails toilet seats and lab coats, and that Winnipeg’s overall hospital-infection rates are on par or even lower than the national average.
So what on earth are we supposed to do if the very place and the people in it that we turn to for help turn out to be a source of the problem?
The uncomfortable truth is that there doesn’t appear to be a good answer. For example, even though health officials stress the importance of routine hand washing to all staff, studies find less than 40 per cent of health-care workers wash their hands properly, and that staff don’t follow infection-control guidelines simply because they’re so busy. Encouraging patients to ask doctors and nurses whether they’ve washed their hands is also proposed, however the idea that a sick, vulnerable person will confront the very (powerful by comparison) people needed to help them seems to be a dubious proposition.
Finally, there is this lesson. About 3 in the morning a 34 year old healthy man woke up because he felt a pressure sensation in his face. He went to the bathroom and saw in the mirror a swelling on his jaw. Being aware of a MRSA epidemic in the city where he lived he got help immediately. Sure enough, a MRSA infection was diagnosed and over the ensuing days his face “looked like [it] had been beaten in a bare-knuckled boxing match.” But he got lucky; his quick action and access to local healthcare was able to overcome the infection in a week.
Just who was this person? The very guy who is warning us about just what tricky places hospital can be – - Brad Spellberg, MD.