US Hospitals Say They’re Ready for Coronavirus. Their Infection Control Violations Say Otherwise.

Marshall Allen, Caroline Chen, J. David McSwane and Lexi Churchill (ProPublica) 04 March 2020

Life

An outbreak would demand peak performance from America’s medical professionals — especially in hospitals. But many of the facilities that may be on the front lines have well-documented histories of failing to prevent the spread of infectious diseases.

In early February, Royal Caribbean’s Anthem of the Seas docked in Bayonne, New Jersey, in need of a hospital. The cruise ship was carrying patients who had traveled from China, where an outbreak of COVID-19 had taken root. Four passengers needed to go somewhere for further medical observation.

The obvious next step was University Hospital in Newark, a major academic medical center equipped with isolation rooms. “The hospital is following proper infection control protocols while evaluating these individuals,” Gov. Phil Murphy said in a statement. The patients tested negative, but the governor was clear. The state’s first coronavirus cases would go to University.

That’s a hospital that has struggled in recent years with a critical skill essential to battling COVID-19: controlling the spread of infection.

Less than two years ago, a deadly bacteria made its way through the facility. Three babies in the neonatal intensive care unit got infected and died. Government inspectors cited the hospital for being short of staff; failing to maintain a sanitary environment, including improper hand hygiene and sterilization; and inadequately isolating patients with respiratory conditions. They determined the hospital had put patients in “immediate jeopardy.”

Today, the state’s former health commissioner, Dr. Shereef Elnahal, is in charge of the hospital. He told ProPublica its infection control problems are a thing of the past. The violations cited in the report were corrected with increased screening of patients, improved handwashing and equipment and focused leadership, Elnahal said. “I’m proud of our progress since then,” he said. Murphy’s office directed inquiries to the state’s Department of Health, where a spokeswoman said there is “complete confidence” in the hospital’s ability to manage the coronavirus response.

But infection control has been a recurring problem at some of the very hospitals that would likely be called upon to treat COVID-19 patients, a ProPublica review of hundreds of hospital inspection reports found. This raises concerns that they could become hotbeds for disease, putting patients at risk and rendering infected workers unable to care for others.

“Health care workers are my top worry,” said Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston. He noted that in China, so far, about 15% of infected hospital workers have become severely ill. “If this takes place in the U.S., and we see those numbers of workers sent home or in the ICU, being taken care of by their colleagues, things will start to unravel. This is the soft underbelly of our preparedness system right now.”

At least two health care workers in Northern California had preliminary positive tests for COVID-19 at NorthBay VacaValley Hospital, pending CDC confirmation. The hospital had treated a patient who later tested positive for the disease. Other health care workers who came into contact with the patient are also in quarantine.

There is no list of designated centers to handle the most critical COVID-19 patients, experts said. Continue Reading…

Courtesy: ProPublica.org

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