Thursday, December 28, 2006

And the Survey Says . . .

 

# 265

 

In a newly released survey, 28% of healthcare workers stated that they believed it was professionally acceptable for HCP (Health Care Professionals) to abandon their workplaces during a pandemic in order to protect themselves and their families.

 

And while that may sound like bad news, the worse news is that only 52%, or a bare majority, felt it was unacceptable. 19% of respondents had no opinion.

 

The abstract for this survey, conducted by BMC Public Health, is available at

http://tinyurl.com/yk9wgm

 

While not totally unexpected, these results cast doubt on `official projections’ that up to 40% absenteeism might be experienced by hospitals during a pandemic. As stated many times before in this blog, I believe that number is optimistic.

 

Health care workers, by the vary nature of their work; will be exposed far more to the virus than most people, and the attack rate should be at its maximum among HCP’s. If the 30% attack rate (again, likely an optimistic assumption) is added to the roughly 30% who would choose not to work during a pandemic, we end up with greater than a 50% reduction in the health care work force.

 

If the attack rate is higher than 30%, or a significant portion of those with `no opinion’ decided to err on the side of caution and stay home, those numbers get even worse.

 

While it would be easy to damn those who would abandon their posts during a crisis, it should be noted that most hospitals have done little to prepare for a pandemic. PPE’s (Personal Protective Equipment) such as masks, gowns, gloves, and face shields are not being stockpiled in sufficient quantity. In many places, hospitals are attempting to substitute cheaper surgical masks, instead of the more effective N95 masks, due to cost considerations.

 

Firefighters would not be expected to run into a burning building without their bunker gear, but apparently health care workers are expected to expose themselves to the virus without essential protective equipment.

 

The fear of the H5N1 bird flu virus runs deep among HCP’s, as does mistrust of hospital administrators. They remember that nurses in Canada were not informed early on during the SARS outbreak how infectious the disease really was, and several of them succumbed to it for lack of proper protective equipment. No doubt, memories of that debacle are a contributing factor in this survey.

 

According to this survey, Doctors were the most likely to work during a pandemic (65%), followed by nurses (54%), with administrators being the least likely (32%).

 

No mention was made of other health care workers, such as technicians, lab personnel, nurses aids, housekeeping, laundry, or kitchen staff. All of which are essential in keeping a hospital running.

 

While a certain percentage of these workers would likely not work even if provided with the proper protective equipment, one thing is certain. Without the right PPE’s, and in sufficient quantities, hospitals will quickly collapse from the loss of health care workers. Many will catch the virus, while some will simply walk away, unwilling to risk exposure.

 

Any hope of keeping hospitals open and running, even at a dramatically reduced capacity, hinges on having the proper protective equipment on hand.

 

While our government is spending billions of dollars attempting to come up with a high tech vaccine for the H5N1 virus, they are largely ignoring the more basic protective measures. They appear to be leaving it up to individual hospitals to decide how much in the way of PPE’s they should have on hand.

 

And that, in the end, may prove to be a tragic miscalculation.