A complete lack of preparation and training, the use of wrong protocols and just lack of common sense 160 years after the experiments of Louis Pasteur, have converted once again healthcare facilities (hospitals, nursing and care homes) in the worst focuses of infection and deaths during the COVID-19 crisis. On this post, I concentrate on hospitals, on future posts I will comment other healthcare facility related mismanagement issues.
According to the WHO,
- Health care-associated infections are the most frequent adverse event in health-care delivery worldwide.
- Hundreds of millions of patients are affected by health care-associated infections worldwide each year, leading to significant mortality and financial losses for health systems.
- On average, 4 131 000 patients are affected in European countries and 1.7 million in the US each year.
This is what happens in normal times. It is generally known both by the public and health professionals, yet progress has been too slow. But this is another story.
It should be obvious that the best way to contain any epidemic is to ensure that patients don’t get infected by the new disease in hospitals. In the case of the COVID-19 disease, which affects disproportionately people with existing conditions, this is even more important because it was determined very early that hospitals concentrate the more severely at-risk population.
I believe that infections produced on healthcare facilities accounted for most of the deaths caused by the virus in those places that caused the initial panic in the first place: Milan, Madrid and NYC.
In other words, if hospitals had been prepared, the COVID-19 disease could have just been lost in the noise of other many respiratory diseases that afflict us. It would have been known that the ‘2020 flu season‘ was big, and somewhat late during the year, peaking in March or April, rather than on January, but that would have been it.
What is more important, as the pandemic has run its course in different countries, much of the difference between countries, and between regions within countries, will be explained at the end by this single factor (and most of the rest by the different outcomes in other healthcare facilities, such as nursery and care homes).
In other words, as soon as it became evident that a highly infectious new respiratory disease was spreading, hospitals should have started a well established protocol that ensured that new infectious patients admitted to the hospital did not provoke nosocomial, or Healthcare associated infections (HCI), thus amplifying unnecessarily the epidemic.
These protocols are not that difficult to implement. They are based on segregating infected patients, optimally deriving infected patients to different hospitals, and protecting healthcare personnel from infection. It is not rocked science.
These are the first questions I would ask Public Health Authorities:
- Why such protocols were not in place?
- Why were they not implemented immediately?