This is one major reason why I always rail against single payer medicine. Bureaucracies do not learn from experience, because they don't have to. They glide around experience and get back to business as usual as quickly as possible.
Canada is poorly prepared to contain outbreaks of dangerous diseases and lacks an effective method to track people who may be infected, according to a newly released Defence Department study.
The report, obtained by the Citizen, also recommends isolating Canadian troops who have served in high-risk disease areas at an offshore holding site for 21 days to prevent the entry of deadly viruses into the country.
"Canada as a whole is poor on all containment matters, as evidenced by the recent spread of SARS within Ontario hospitals," concludes the study produced last year by the Defence Science Advisory Board.
It noted what it called significant gaps in dealing with exotic or new diseases. The board believes Canada needs a better system of surveillance for both animals and humans who may come down with unusual illnesses. It also recommends improving the tracking of individuals who may have exotic diseases.
"In some provinces in Canada, hospitals seeing exotic symptoms take travel histories but do not record the address (permanent or temporary) of the patient, so tracking is hopeless," added the study, obtained through the Access to Information law.
The Defence Science Advisory Board, made up of experts drawn from industry and academia, provides independent advice to the Defence Department.
We dodged a bullet with SARS just two years ago. The ONLY visible change post-SARS in Ontario hospitals is that they have little pots of hand cleaner sitting out beside the elevators and entrances. Waiting rooms are the same. Infection control remains a joke. One hospital in Hamilton which I will not name still doesn't clean their bathrooms every day. You see the same boogers stuck to the wall, that's how I know. I drew a circle around one, booger and circle were still there the next day.
Here's my favorite quote that sums up the problem in one sentence:
Yep. That would pretty much nail the problem. The problem is, infection control is not sexy. It doesn't make for good TV. Isolation rooms with filtered exit air are expensive and don't offer much latitude for the Po-Mo designer set. White hi-gloss paint and waxed floors are so 1920's. White nurse's uniforms are sexist, hand washing is hard on the skin, latex gloves cause allergies, blah blah blah and besides we don't have enough nurses.
The board also recommended that troops serving in areas where there have been incidents of highly transmittable viruses, such as Ebola or Lassa fevers, be quarantined before being allowed to return to Canada. Those soldiers should be sent to an "extraterritorial holding site (isolation) for 21 days," the report added. It noted the incubation period for any new or virulent viral disease is unlikely to be longer than three weeks.
"We strongly support such a third-site firewall approach for deployments to some areas of Africa, Asia and South America," the report stated.
The board acknowledged such a policy would prevent "dignitaries looking for photo-ops" from visiting such military missions overseas since the politicians would also be required to be quarantined and could not afford to spend three weeks in isolation.
Therefore modern hospitals are built to look like the Holiday Inn. Much more welcoming and much easier to staff.
Trouble is, all that carpet and those lovely textured surfaces are like a big ol' petri dish. Wanna know why C. Difficile infections are killing old ladies by the bus load every year in Canada? Carpet. Bad hand washing. Nobody washes the walls because it discolours the nice vinyl wallpaper. Containment suits? Are you nuts? It'll scare the kiddies!
When they move you into a room where some poor bastard has just died of drug resistant TB and laid there three weeks before he kicked off, all they change are the curtains and the sheets, maybe they vacuumed the carpet. Steam clean once a year whether it needs it or not, don't ask what may be growing underneath there in the spilled orange juice and pee stains. Clean the bed? Why?
The real problem of course is that we have antibiotics that will kill damn near everything that's transmissible. There hasn't been a killer disease to worry about since they whipped polio in the 1950's. Nobody working today remembers when catching a bug could kill you in 24 hours or leave you in an iron lung. There's millions dying of HIV world wide, but because we have HIV control drugs available the government hasn't even seen fit to close down the sex clubs that spread it.
However we do not have anti-virals worth a damn. If you catch Ebola, you're screwed. Bird flu, you're screwed. These things can have vaccines made against them, but that takes a loooong time.
In a world where we have bird flu with 50% mortality romping about in Asia and looking like its going to become the next big killer, plus we have wild eyed Muslim fruit bats just itching to lay a plague on the Great Satan, the smart thing to do would be spend some money and time on infection control in hospitals and beefing up our vaccine production infrastructure. We could cut down the vaccine development time and the production time with some focused effort I'm sure.
But it doesn't give good photo ops. Bummer, lets focus on Stephen Harper's hairdo instead.
Clearly nobody is going to do anything useful until a couple hundred doctors and nurses die of the next SARS, whatever that is. Maybe ten thousand or so regular people, I guess it depends if they live in Toronto or not. Less than a dozen nurses died last time, not enough to get anyone's attention it seems.
16 people died of a Legionella outbreak in Toronto this year and they fucked around for two weeks before they figured out what was going on. They sent the patients sick with an unknown and possibly contagious FATAL disease to nine different hospitals. I'd say that alone proves my case.
So, until we get a daily body count ticker on the TV news, with four digits at least, it will be business as usual. Welcome to socialized medicine and photo-op politics.
The Sick of the Bullshit Phantom